The Fungi Flora of Healthy Nasal Mucosa in Kerman, Iran

Document Type : Original

Authors

1 Department of biostatistics and epidemiology Department, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran

2 Department of otorhinolaryngology, Kerman University of Medical Sciences, Kerman, Iran

3 Department of medical mycology and parasitology, Kerman University of Medical Sciences, Kerman, Iran

Abstract

Introduction:
Environmental fungi, molds and yeasts, can infest the nasal cavity through inhaled air. There is some evidence that they could be the main cause of Chronic Rhinosinusitis (CRS) but little is known about the normal fungal flora in the human nose.
The objective of this study was to assess the normal fungal flora of the nasal mucus in adults in Kerman.
Materials and Methods:
We conducted a cross sectional study. Nasal swabs were used to sample the nasal cavity of 100 adults, 46 men and 54 women between 17 and 60 years old, currently living in Kerman, Iran.
Results:
Among 100 healthy people, one or more types of fungi were detected in 31 (31%) persons; Candida in 12 persons, Aspergillus in 8 persons, Streptomyces in 8 persons, and Penicillium, Nocardia and Mucor in a few persons. In only 4 persons, more than one type of fungi was detected.  There was no significant relation between age, sex, education or smoking with the presence of fungi.
Conclusion:
Fungi have been considered one of the causative agents of CRS and differences in climatic conditions can influence the fungi flora.

Keywords


  1. Kaliner MA, Osguthorpe JD, Fireman P, Anon J, Georgitis J, Davis ML, et al. Sinusitis, bench to bedside. Current findings, future directions. J Allergy Clin Immunol 1997; 99(6 pt 3): 829-48.
  2. Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, et al. Clinical practice guideline: Adult sinusitis. Otolaryngol Head Neck Surg 2007; 137: 1-31.
  3. Mozaffarnia K. [Sinisitis and its treatment in children]. 1st Tehran: Fanoos; 2008. (Persian)
  4. McDonald TJ. Nasal manifestations of diseases. In: Cummings CW, Flint PW, Harker LA, Hahghey BH, Richardson MA, et al. (editors). Cummings otolaryngology head  and neck surgery. 4th Philadelphia: Elsevier Mosby; 2005: 936-41.
  5. Boone JL. Etiology of infectious diseases of the upper respiratory tract. In: Snow JB, Ballenger JJ. (editors). Ballenger's otorhinolaryngology, head and neck surgery. 16th Hamilton, Ontario, Canada: BC Decker; 2003: 633-51.
  6. Jonathan D, Lund V, Milroy C. Allergic aspergillus sinusitis, an overlooked diagnosis? J Laryngol Otol 1989; 103(12): 1181-3.
  7. Kinsella JB, Bradfield JJ, Gourley WK, Calhoun KH, Rassekh CH. Allergic fungal sinusitis. Clin Otolaryngol Allied Sci 1996; 21(5): 389-92.
  8. Katzenstein AA, Sale SR, Greenberger PA. Allergic aspergillus sinusitis, a newly recognized form of sinusitis. J Allergy Immunol 1983; 72: 89-93.
  9. Manning SC. Culture positive allergic fungal sinusitis. Arch Otolaryngol Head Neck Surg 1991; 117(2): 174-8.
  10. Catten MD, Murr AH, Goldstein JA, Mhatre AN, Lalwani AK. Detection of fungi in the nasal mucosa using polymerase chain reaction. Laryngoscope 2001; 111(3): 399-403.
  11. Dall'Igna C, Palombini BC, Anselmi F, Araújo E, Dall'Igna DP. Fungal rhinosinusitis in patients with chronic sinusal disease. Braz J Otorhinolaryngology 2005; 71(6): 712-20.
  12. Meikle D, Yarington CT, Winterbauer RH. Aspergillosis of the maxillary sinuses in otherwise healthy patients. Laryngoscope 1985; 95(7 pt 1): 776-9.
  13. Douglas R, Bruhn M, Tan LW, Ooi E, Psaltis A, Wormald PJ. Response of peripheral blood lymphocytes to fungal extracts and staphylococcal superantigen B in chronic rhinosinusitis. Laryngoscope 2007; 117(3): 411-4.
  14. Buzina W, Braun H, Freudenschuss K, Lackner A, Habermann W, Stammberger H. Fungal biodiversity-as found in nasal mucus. Med Mycol 2003; 41: 149-61.
  15. Ebbens FA, Fokkens WJ. The mold conundrum in chronic rhinosinusitis: Where do we stand today? Curr Allergy Asthma Report 2008; 8(2): 93-101.
  16. Lackner A, Freudenschuss K, Buzina W, Stammberger H, Panzitt T, Schosteritsch S, et al. [From when on can fungi be identified in nasal mucus of humans?]. Laryngo Rhino Otologie 2004; 83(2): 117-21. (German)
  17. Darwazeh AM, Al-Dosari A, Al-Bagieh NH. Oral candida and nasal aspergillus flora in a group of Saudi healthy dentate subjects. Int Dent J 2002; 52(4): 273-7.
  18. Sellart-Altisent M, Torres-Rodríguez JM, Gómez de Ana S, Alvarado-Ramírez E. Nasal fungal microbiotica in allergic and healthy subjects. Rev Iberoam Micol 2007; 24(2): 125-30. (Spanish)
  19. Ponikau JU, Sherris DA, Kern EB, Homburger HA, Frigas E, Gaffey TA, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc 1999; 74(9): 877-84.
  20. Tabatabaei A, Farhadi M, Nourbakhsh S, Mohammadi S, Falak R. [Fungal infection in patients with polyposis in groups with high and normal IgE, referred for surgery to the ENT ward of the Rasool Akram Hospital]. Iran Med Uni J 2006; 13(50): 99-105. (Persian)