Abstract:
Fungal sinusitis is increasingly recognized, both in normal and
immunocompromised individuals. Fungal sinusitis, if not diagnosed early
and treated promptly, can cause severe complications, which in some
patients could be fatal, hence early laboratory diagnosis is very
important to prevent recurrences and complications.
The objectives of this study is to determine the fungi causing nasal and
paranasal infections in Sudanese patients.
In this study 488 specimens (244 nasal biopsies and 244 blood) were
collected. The 244 nasal biopsies were examined directly using 20% KOH
and cultured on Sabouraud’s dextrose agar for primary isolation.
Counterimmuno-electrophoresis (CIE) was done for the 244 patients’ sera.
Eighteen of A. flavus isolates were tested for aflatoxin production by thin
layer chromatography (TLC).
One hundred and seven specimens (43.1%) gave fungal hyphae in direct
microscopy and yielded fungal growth. Eighty nine of them (83.3%) grew
A.flavus, 6 (5.6%) grew A. terreus, 6 (5.6%) grew Bipolaris sp.. One (0.9%)
yielded Curvularia lunata, 1 (0.9%) yielded A.nidulans, 1 (0.9%) grew
black yeast and 1 (0.9%) grew Conidiobolus coronatus (Zygomycetes), but
2(1.9%) Dematiaceous cultures were unidentified.
Seventy nine (73.8%) patients’ sera of the positive cultures gave precipitin
lines in the CIE. This indicated the correlation between isolates and their
serological testing.
Eighteen of A. flavus isolates were tested for aflatoxin production by thin
layer chromatography (TLC), 17 of them (94.4 %) were positive; this high
percentage of aflatoxin detection indicates their possible role in the
pathogenicity of this microorganism.
In conclusion the combination of biopsies, for direct microscopy, fungal
growth and identification and serology is of great importance for good
diagnosis.
