The aetiology of fungal sinusitis is diverse and changing. Aspergillus species has been the most common cause for fungal sinusitis, especially in dry and hot regions like India. Trichosporon species as a cause for fungal sinusitis has been very rarely reported the world over. Here, we report a rare case of allergic fungal sinusitis caused by Trichosporon inkin in a 28-year-old immunocompetent woman. Bilateral nasal obstruction, nasal discharge and loss of smell were her presenting complaints. Diagnostic nasal endoscopy showed bilateral multiple polyps. Functional endoscopic sinus surgery was performed and many polyps were removed. Based on mycological and histopathological studies, the pathogen was identified as T. inkin.
Biofilm formation by respiratory pathogen favour their colonization, persistence and virulence. Cigarette smoke have the ability to cause induction and increase in biofilm formation. This quantitative in vitro study is aimed at understanding the dose-dependent change in the biofilm formation, which can be correlated to the degree of virulence of the respiratory pathogens. Materials and Methods: In the present study, 77 respiratory isolates of non-smokers were included. They were processed and exposed to varying concentrations of Cigarette Smoke Extract (CSE).Quantification of biofilm production was done according to the Microtitre dish biofilm formation assay. Fischer's exact test was used to compare the biofilm production status. Results: We observed that 42[80.77%] isolates out of 52 biofilm producers and 12[48%] isolates out of 25 non-biofilm producers were found to show an increase in Biofilm index (BFI) with exposure to CSE. Among the total of 77 respiratory isolates, 32 isolates accounting for 41.57% [95% CI; 30.6% to 52.6%] showed a dose-related augmentation of biofilm formation on exposure to CSE. Interpretation and Conclusions: Progressive increase of biofilm with increase in concentration of CSE was the major finding. This emphasizes the need to initiate appropriate empirical therapy for smokers at the earliest.
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