Journal de pathogenèse microbienne

A Case of Allergic Fungal Sinusitis Due to Alternaria alternata

Abstract

Abdolrasoul Mohammadi, Mahnaz kheirkhah, Seyed Mostafa Hashemi, Sayed Hamidreza Abtahi, Seyed Mohammad Lajevardi, Rasoul Mohammadi*

Introduction: Allergic fungal sinusitis may be seen in 10% of patients with chronic rhinosinusitis and polyposis. The disease caused due to allergic reaction to aerosolized environmental conidia of fungi. It is most prevalent in young adults. Diagnostic criteria for AFS contain findings at surgery of allergic mucin, radiologic evidence of pansinusitis, positive fungal cultures and immunological tests for both cellular and humoral immune responses. Various fungi such as hyaline fungi, yeasts, and dematiaceous fungi have been involved in allergic fungal sinusitis.
Case: Herein, we present a case of AFS in a 36-year old female due to a rare dematiaceous fungus. She had bilateral nasal congestion and antrochoanal polyps. After bilateral nasal polyp surgery (BNPS), clinical samples were sent to the medical mycology laboratory in serum saline for direct microscopic examination and culture. ITS1-5.8SITS2 region was amplified using universal fungal primers ITS1 and ITS4, and the amplicon was applied for sequencing. Sequence analysis was used to confirm phenotypic findings and Alternaria alternata was identified as causative agent of AFS.
Conclusion: Molecular techniques can be used as an effective tool for identification of microorganisms in clinical specimens that provide a precise presentation of the epidemiology of microorganisms and effective control of rare fungal infections.