What is the role of lab studies in the diagnosis of fungal sinusitis?

Updated: Mar 17, 2020
  • Author: Hassan H Ramadan, MD, MSc; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Elevated total fungus-specific IgE concentrations are often found in patients with allergic fungal sinusitis. This is less common in patients with sinus mycetoma.

Using enzyme-linked immunosorbent assays, one study examined the sinonasal tissue and secretions in patients with chronic rhinosinusitis for the presence of mycotoxins (ie, aflatoxin, deoxynivalenol, zearalenone, ochratoxin, and fumonisin) to determine their possible role, if any, in chronic rhinosinusitis. No mycotoxins were found, except ochratoxin in 4 of 18 samples. The clinical significance of these results has not been determined. [11]

A study by Payne et al of 41 patients with acute invasive fungal rhinosinusitis reported that predictive variables for the disease include an absolute neutrophil count below 500/μL (sensitivity of 78%), abnormalities of the septal mucosa (specificity of 97%), and necrosis and mucosal abnormalities of the middle turbinate (specificities of 97% and 88%, respectively). [12]


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