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Journal of Clinical Microbiology, February 2003, p. 581-585, Vol. 41, No. 2
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.2.581-585.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Detection and Identification of Fungi from Fungus Balls of the Maxillary Sinus by Molecular Techniques

Birgit Willinger,1* Alexandra Obradovic,1,{dagger} Brigitte Selitsch,1 Johann Beck-Mannagetta,2 Walter Buzina,3 Hannes Braun,3 Petra Apfalter,1 Alexander M. Hirschl,1 Athanasios Makristathis,1 and Manfred Rotter1

Division of Clinical Microbiology, Institute of Hygiene and Medical Microbiology, University of Vienna, Vienna,1 Department of Oral and Maxillo-Facial Surgery, Landeskrankenhaus, Salzburg,2 ENT University Hospital, Karl-Franzens-University, Graz, Austria3

Received 5 August 2002/ Returned for modification 25 September 2002/ Accepted 14 November 2002

The aim of this study was to find a reliable method for the detection and identification of fungi in fungus balls of the maxillary sinus and to evaluate the spectrum of fungi in these samples. One hundred twelve samples were obtained from patients with histologically proven fungal infections; 81 samples were paraffin-embedded tissue sections of the maxillary sinus. In 31 cases, sinus contents without paraffin embedding were sent for investigation. PCR amplification with universal fungal primers for 28S ribosomal DNA and amplicon identification by hybridization with species-specific probes for Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus terreus, Aspergillus glaucus, Pseudallescheria boydii, Candida albicans, and Candida glabrata were performed for all samples. Furthermore, PCR products were sequenced. Fresh samples were also cultivated. Fungal DNA was detected in all of the fresh samples but only in 71 paraffin-embedded tissue samples (87.7%). Sequence analysis was the most sensitive technique, as results could be obtained for 28 (90.3%) fresh samples by this method in comparison to 24 (77.4%) samples by hybridization and 16 (51.6%) samples by culture. However, sequence analysis delivered a result for only 36 (50.7%) of the paraffin-embedded specimens. Hybridization showed reliable results for A. fumigatus, which proved to be the most common agent in fungus balls of the maxillary sinus. Other Aspergillus species and other genera were rarely found.

* Corresponding author. Mailing address: Division of Clinical Microbiology, Institute of Hygiene and Medical Microbiology of the University, Vienna University Hospital, Währinger Gürtel 18-20/5P, A-1090 Vienna, Austria. Phone: 0043-1-40400/5151. Fax: 0043-1-40400/5228. E-mail: birgit.willinger{at}akh-wien.ac.at.

{dagger} Present address: University Department of Accident Surgery, Vienna University Hospital, Vienna, Austria.

Journal of Clinical Microbiology, February 2003, p. 581-585, Vol. 41, No. 2
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.2.581-585.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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