TY - JOUR
T1 - In situ hybridization for specific fungal organisms in acute invasive fungal rhinosinusitis
AU - Montone, Kathleen T.
AU - LiVolsi, Virginia A.
AU - Lanza, Donald C.
AU - Kennedy, David W.
AU - Palmer, James
AU - Chiu, Alexander G.
AU - Feldman, Michael D.
AU - Loevner, Laurie A.
AU - Nachamkin, Irving
PY - 2011/2
Y1 - 2011/2
N2 - Acute invasive fungal rhinosinusitis (AIFRS) most commonly occurs in immunosuppressed patients. The identification of fungal subtypes is important for management, and cultures can be negative. We studied 55 specimens from 23 patients with AIFRS (Rhizopus sp, 6; Aspergillus sp, 8; Fusarium sp, 1; Alternaria sp, 1; and culture negative, 7) using in situ hybridization (ISH) with biotin-labeled oligonucleotide probes targeting Aspergillus sp, Fusarium sp, Rhizopus sp, and a sequence identified in dematiaceous fungi. Ribosomal RNA preservation was established by using a pan-fungal probe. Nucleic acid preservation was seen in 18 patients (33 specimens [60%]). ISH using the specific fungal probes highlighted the respective fungal organisms in all culture-positive cases with adequate negative controls. Of the 7 culture-negative AIFRS cases, 4 had preserved fungal sequences. Of these cases, 2 additional cases of Aspergillus and 1 additional case of dematiaceous species were identified. In our study, 60% of AIFRS cases had fungal nucleic acid preservation. ISH can effectively identify fungi in AIFRS. ISH for specific fungal pathogens may aid in species identification in specimens with negative cultures.
AB - Acute invasive fungal rhinosinusitis (AIFRS) most commonly occurs in immunosuppressed patients. The identification of fungal subtypes is important for management, and cultures can be negative. We studied 55 specimens from 23 patients with AIFRS (Rhizopus sp, 6; Aspergillus sp, 8; Fusarium sp, 1; Alternaria sp, 1; and culture negative, 7) using in situ hybridization (ISH) with biotin-labeled oligonucleotide probes targeting Aspergillus sp, Fusarium sp, Rhizopus sp, and a sequence identified in dematiaceous fungi. Ribosomal RNA preservation was established by using a pan-fungal probe. Nucleic acid preservation was seen in 18 patients (33 specimens [60%]). ISH using the specific fungal probes highlighted the respective fungal organisms in all culture-positive cases with adequate negative controls. Of the 7 culture-negative AIFRS cases, 4 had preserved fungal sequences. Of these cases, 2 additional cases of Aspergillus and 1 additional case of dematiaceous species were identified. In our study, 60% of AIFRS cases had fungal nucleic acid preservation. ISH can effectively identify fungi in AIFRS. ISH for specific fungal pathogens may aid in species identification in specimens with negative cultures.
KW - Acute invasive fungal rhinosinusitis
KW - Aspergillus
KW - Fusarium
KW - In situ hybridization
KW - Rhizopus
KW - Ribosomal RNA
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U2 - 10.1309/AJCPQLYZBDF30HTM
DO - 10.1309/AJCPQLYZBDF30HTM
M3 - Article
C2 - 21228359
AN - SCOPUS:79952271334
SN - 0002-9173
VL - 135
SP - 190
EP - 199
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 2
ER -