Allergic Rhizomucor sinusitis

Goldstein, Michael S.; Dvorin, Donald J.; Dunsky, Eliot H.; Lesser, Raymond W.; Heuman, Paul J.; Loose, Jeffrey H.

doi:10.1016/s0091-6749(05)80020-x

Cited by 35 publications

(7 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Elevated serum IgE, positive immediate skin testing, and positive serum precipitins have also been described in the case of a 12–year‐old boy culturing Fusarium 47 . Goldstein et al 48 have also described AFS caused by a Rhizomucor species with peripheral eosinophilia but normal total serum IgE.…”

Section: Immunologic Findingsmentioning

confidence: 95%

Further evidence for allergic pathophysiology in allergic fungal sinusitis

1998

View full text Add to dashboard Cite

Controversy continues over whether allergic fungal sinusitis represents a true allergy, an infection, or a point somewhere along a spectrum between allergy and infection. The present study describes two experiments that add weight to the argument that allergic fungal sinusitis (AFS) is truly an immunologically mediated hypersensitivity and not a form of infection. In the first experiment, eight patients with Bipolaris culture-positive AFS were prospectively evaluated with Bipolaris antigen skin testing and with inhibition radioallergosorbent (RAST) and enzyme-linked immunosorbent assay (ELISA) for Bipolaris-specific IgE and IgG antibodies. The Bipolaris AFS cases were compared with 10 control patients with no history of AFS. All eight AFS cases demonstrated positive skin testing to Bipolaris and in addition, all tested positive by RAST and ELISA for IgE and IgG Bipolaris antibodies, respectively. In the control group one patient had a positive skin test, ELISA, and RAST and one additional patient had a positive ELISA only. Good correlation was noted between skin test, RAST, and ELISA results. In the second experiment, sinus mucosa from 14 AFS patients and 10 control patients with other forms of surgical sinus disease was analyzed by immunohistocytochemistry for the eosinophilic inflammatory mediators major basic protein (MBP) and eosinophil derived neurotoxin (EDN) and the neutrophil mediator neutrophil elastase. All AFS cases demonstrated evidence of eosinophilic mediator release, and MBP and EDN predominated over neutrophil elastase. In the control group eosinophil and neutrophil mediator release in sinus mucosa was equal. The two experiments support the concept that AFS is an antigen-triggered, IgE- and IgG-mediated hypersensitivity response with a late-phase inflammatory reaction involving release of eosinophilic mediators.

show abstract

Section: Immunologic Findingsmentioning

confidence: 95%

Further evidence for allergic pathophysiology in allergic fungal sinusitis

1998

View full text Add to dashboard Cite

show abstract

“…Angioinvasion is often seen and may result in systemically disseminated disease (181,243,260,291,367). Decidedly uncommon forms of rhinofacial disease published in the literature include isolated sinusitis (172) and calcified fungal ball of the sinus (176). Early cases with rhinocerebral zygomycosis were almost uniformly fatal (181,260,356).…”

Section: General Disease Manifestationsmentioning

confidence: 99%

Zygomycetes in Human Disease

Ribes¹,

Vanover-Sams²,

Baker³

2000

Clinical Microbiology Reviews

1,092

1,053

View full text Add to dashboard Cite

“…The limited success of the current therapies mainly stems from the rapidly progressive nature of these infections and the low number of antimycotics that can be applied (3,5,10). An expanding body of data is becoming available that demonstrates the opportunistic pathogenic role of the members of the genus Rhizomucor (1,2,4,5,9,11,16). This genus involves two ubiquitous species: R. pusillus and R. miehei.…”

mentioning

confidence: 99%

“…An expanding body of data is becoming available that demonstrates the opportunistic pathogenic role of the members of the genus Rhizomucor (1,2,4,5,9,11,16). This genus involves two ubiquitous species: R. pusillus and R. miehei.…”

mentioning

confidence: 99%

Differentiation of Rhizomucor Species on the Basis of Their Different Sensitivities to Lovastatin

Lukács

Papp²,

Nyilasi

et al. 2004

J Clin Microbiol

View full text Add to dashboard Cite

The opportunistic pathogens Rhizomucor pusillus and Rhizomucor miehei may be agents of frequently fatal mycotic diseases. In the present study, the susceptibilities of 27 clinical and environmental isolates of R. miehei and R. pusillus to lovastatin under different culturing conditions were investigated. Most of the R. miehei strains grew at lovastatin concentrations as high as 64 to 128 g/ml. In contrast, the inhibitory effect of lovastatin on all of the R. pusillus strains was evident at lovastatin concentrations as low as 1 to 2 g/ml. A simple and reliable method for species-level differentiation, based on the significantly higher sensitivity of R. pusillus to lovastatin than that of R. miehei, was elaborated. According this, on malt extract agar containing 6 g of lovastatin/ml, R. pusillus is not able to produce colonies, while R. miehei will form compact colonies.A growing number of susceptible hosts form a high-risk population for opportunistic fungal infections. Among these, zygomycosis comprises a diverse group of increasingly recognized mycotic diseases caused by some members of the orders Entomophthorales and Mucorales (e.g., Absidia, Mortierella, Rhizomucor, and Rhizopus [5]). In spite of the fact that these mycoses are in most cases limited to patients with a challenged and weakened immune system, they are attracting even more attention because of their frequently fatal outcome. The limited success of the current therapies mainly stems from the rapidly progressive nature of these infections and the low number of antimycotics that can be applied (3,5,10).An expanding body of data is becoming available that demonstrates the opportunistic pathogenic role of the members of the genus Rhizomucor (1,2,4,5,9,11,16). This genus involves two ubiquitous species: R. pusillus and R. miehei. Their thermophilic nature and characteristic morphological features, such as the presence of stolons, rhizoids, and repeatedly branched sporangiophores, clearly distinguish them from most members of the Mucorales (7). At the same time, the identification of Rhizomucor isolates at a species level seems to be problematic, frequently resulting in misidentifications, or the species names remain to be determined.There are several approaches that may be of help in the identification of Rhizomucor species, but all of these methodologies involve unresolved problems and limitations. Determination of the number of nuclei in the sporangiospores (12) or morphological characterization of the zygospores (the diameter is Ͻ50 m and Ͼ50 m for R. miehei and R. pusillus, respectively) (7, 15) has some potential in providing characters for species delimitation, but the results are not clear-cut in most cases. It is also known that homo-and heterothallic Rhizomucor strains do not group according to species: R. miehei involves only homothallic strains, but both hetero-and (rarely) homothallic R. pusillus isolates are known (7). Assimilation differences can also be used to differentiate these organisms: an inability to assimilate sucrose, glycine, ...

show abstract

Allergic Rhizomucor sinusitis

Cited by 35 publications

References 52 publications

Further evidence for allergic pathophysiology in allergic fungal sinusitis

Further evidence for allergic pathophysiology in allergic fungal sinusitis

Zygomycetes in Human Disease

Differentiation of Rhizomucor Species on the Basis of Their Different Sensitivities to Lovastatin

Contact Info

Product

Resources

About