logo
Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137
rus
русский
eng
english

Site search



Correspondence address
310 Mira Street, Stavropol, Russia, 355017

Tel
+7 8652 352524; +7 8652 353229.

Fax
+7 8652 352524.

E-mail
medvestnik@stgmu.ru

Differential diagnostics of noninvasive mycosis of paranasal sinuses: fungal or bacterial ball?

[Otorhinolaryngology]
Natalia Boiko; Vasiliy Mironov; Sergey Bannikov;

The aim of this research was to analyze the contents of the paranasal sinuses in 168 patients with a clinical diagnosis of «fungal ball» who had undergone endonasal endoscopic surgical intervention. The pathological content of paranasal sinuses was subjected to microscopic, microbiological and histopathological examination. The presence of fungi was confirmed in 148 of 168 patients. In 20 cases, the presence of fungi in the caseous masses, obtained during the operation, was not revealed either by microscopic, or by culture, or by histological examination, and in 19 patients bacterial microflora was detected in diagnostically significant titers, most often Bacteroides spp – in 5 patients, Staphylococcus – in 5 patients, Pseudomonas aeruginosa – in 3 patients, 2 cases of Klebsiella pneumoniae and 2 – Actinomyces spp. The above bacteria have an increased ability to form biofilms. To characterize such finds, the term «bacterial ball» is used, by analogy with the «fungal ball», denoting the fungal body of the paranasal sinuses.

Download

References:
1. Denning D. W., Chakrabarti A. Pulmonary and sinus fungal diseases in non-immunocompromised patients. Lancet Infect. Dis. 2017;17(11):357-366. https://doi.org/10.1016/S1473-3099(17)30309-2
2. Koshel V. I., Sirak S. V., Shetinin E. V., Koshel I. V. Morphological changes in the tissues of the maxillary sinus in experimental perforated sinusitis. Meditsinskii vestnik Severnogo Kavkaza. – Medical News of North Caucasus. 2014;9(3):249-254. (In Russ.). http://doi.org/10.14300/mnnc.2014.09070
3. Koshel I. V., Shetinin E. V., Sirak S. V. Pathophysiological mechanisms of odontogenic maxillary sinusitis. Rossiyskaya otorinolaringologiya. – Russian otorhinolaryngology. 2016;84(5):36-42. (In Russ.). https://doi.org/10.18692/1810-4800-2016-5-36-42
4. Yoon Y. H., Xu J., Park S. K., Heo J. H., Kim Y. M., Rha K. S. A retrospective analysis of 538 sinonasal fungus ball cases treated at a single tertiary medical center in Korea (1996–2015). Int. Forum Allergy Rhinol. 2017;7(11):1070-1075. https://doi.org/10.1002/alr.22007
5. Montone K. T. Pathology of fungal rhinosinusitis: a review. Head and neck pathology. 2016;10(1):40-46. https://doi.org/10.1007/s12105-016-0690-0
6. Kolesnikov V. N., Boiko N. V., Bykova V. V. Clinical manifestations of isolated sphenoid sinus disease. Rossiyskaya rinologiya. – Russian rhinology. 2017;25(1):31-35. (In Russ.). https://doi.org/10.17116/rosrino201725131-35
7. Boiko N. V., Bannikov S. A., Lodochkina O. E., Mareev V. V. Peculiarities of the clinical manifestations of fungal balls in the paranasal sinuses. Rossiyskaya rinologiya. – Russian rhinology. 2018;26(1):18-21. (In Russ.). http://doi.org/10.17116/rosrino201826118-21
8. Boiko N. V., Panchenko S. N. The detection of the human papilloma virus during hyperplastic processes in the nose, ears and throat. 2017. Vestnik otorinolaringologii. – Bulletin of Otorhinolaryngology. 2017;82(2);51-54. (In Russ.). https://doi.org/10.17116/otorino201782251-54
9. Piskunov I. S., Glazev I. E. X-ray visualization of chronic mycotic lesions of the nasal cavity and paranasal sinuses of extramaxillary localization. Rossiyskaya rinologiya. – Russian rhinology. 2018;26(1):22-27. (In Russ.). http://doi.org/10.17116/rosrino201826118-21
10. Braun J. J., Bourjat P., Gentine A., Koehl C., Veillon F., Conraux C. Caseous sinusitis. Clinical, x-ray computed, surgical, histopathological, biological, biochemical and myco-bacteriological aspects. Apropos of 33 cases. Ann. Otolaryngol. Chir. Cervicofac. 1997;114(4):105-115.
11. Kim D. K., Lee D. W., Pyo J. Y., Oh Y. H., Cho S. H. Bioballs causing asymptomatic or recurrent acute rhinosinusitis: two cases. J. Rhinol. 2016;23(1):55-59. https://doi.org/10.18787/jr.2016.23.1.55
12. Singh A. K., Gupta P., Verma N., Khare V., Ahamad A. [et al.]. Fungal rhinosinusitis: microbiological and histopathological perspective. J. Clin. Diagn. Res. 2017;11(7): 10-12. http://doi.org/10.7860/JCDR/2017/25842.10167
13. Mitrofanov V. S., Svirshhevskaja E. V. Aspergillez legkih. SPb.: «Foliant»; 2013. (In Russ.).
14. Kim D. K., Wi Y. C., Shin S. J., Jang Y. I., Kim K. R., Cho S. Bacterial ball as an unusual finding in patients with chronic rhinosinusitis. Clin. Otorhinolar. 2018;11(1):40-45. https://doi:10.21053/ceo.2017.00332
15. Welsh O., Vera-Cabrera L., Welsh E., Salinas M. C. Actinomycetoma and advances in its treatment. Clin. Dermatol. 2012;30:372-381. https://doi.org/doi:10.1016/j.clindermatol.2011.06.027
16. Bykova V. V., Zalesskii A. Iu. Rare cause of recurrent nosebleeds. Rossiyskaya rinologiya. – Russian rhinology. 2015;23(1):52-54. (In Russ.). https://doi.org/10.17116/rosrino201523152-54
17. Belyaeva E. V., Kichikova V. V., Nikiforov V. A. Study of the ability to form biolayer by representatives of microbiocenosis of nasopharynx mucosa of practically healthy people. Meditsinskiy almanakh. – Medical almanac. 2014;34(4):49-51. (In Russ.).
18. Sokolova T. M. Microbial biofilms and ways of their detection. Zhurnal Grodnenskogo gosudarstvennogo meditsinskogo universiteta. – Journal of the Grodno State Medical University. 2014;48(4):12-15. (In Russ.).
19. Marsh P. D. Dental plaque as a biofilm and a microbial community – implications for health and disease. BMC Oral. Health. 2006;6(1):14-20. https://doi.org/10.1186/1472-6831-6-s1-s14

Keywords: paranasal sinuses, fungal ball, differential diagnostics


Founders:
Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy