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Identification of pathogens causing invasive fungal rhinosinusitis in surgical biopsies using polymerase chain reaction

Published online by Cambridge University Press:  20 July 2020

S Chaturantabut ,
N Kitkumthorn ,
A Mutirangura ,
N Praditphol ,
A Chindamporn ,
P S Thorner  and
S Keelawat
S Chaturantabut
Affiliation:
Medical Science Program, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
N Kitkumthorn
Affiliation:
Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
A Mutirangura
Affiliation:
Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
N Praditphol
Affiliation:
Department of Pathology, Rajavithi Hospital, Bangkok, Thailand
A Chindamporn
Affiliation:
Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
P S Thorner
Affiliation:
Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
S Keelawat*
Affiliation:
Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
*
Author for correspondence: Dr Somboon Keelawat, Department of Pathology, Faculty of Medicine, Chulalongkorn University, 1873 King Rama IV Street, Bangkok, 10330Thailand E-mail: [email protected]
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Abstract

Background

Invasive fungal rhinosinusitis is associated with high morbidity and mortality. Rapid pathogen identification is mandatory, but fresh tissue is not always available. A polymerase chain reaction method was designed in order to detect fungi in formalin-fixed paraffin-embedded samples. This was applied to a retrospective series of tissue biopsies from Thai patients with invasive fungal rhinosinusitis.

Methods

Tissue blocks from 64 cases yielded adequate DNA. Three sequential polymerase chain reaction were performed: ZP3 (housekeeping gene) and panfungal polymerase chain reactions, and a differentiating polymerase chain reaction based on the 5.8s ribosomal RNA and internal transcribed spacer 2 regions. The polymerase chain reaction products were then sequenced.

Results

Polymerase chain reaction identified a fungal pathogen in 20 of 64 cases (31 per cent). Aspergillus species was the most common cause of invasive fungal rhinosinusitis (nine cases). Other causes included candida (n = 4), cladosporium (n = 4), mucor (n = 1), alternaria (n = 1) and dendryphiella (n = 1) species.

Conclusion

Polymerase chain reaction can provide rapid identification of fungal pathogens in paraffin-embedded tissue, enabling prompt treatment of invasive fungal rhinosinusitis.

Keywords

Invasive Fungal RhinosinusitisPolymerase Chain ReactionAspergillusCandidaCladosporium
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 7 , July 2020 , pp. 632 - 635
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr S Keelawat takes responsibility for the integrity of the content of the paper

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