[The analysis of the bacterial and fungal flora in maxillary sinuses in patients operated due to FESS method]

Chronic Infection with Hidden Malignancy Mimicking the Clinical Presentation of an Autoimmune Disease

Infections of the paranasal sinuses are common and usually occur in patients who are immunocompromised. Many atypical clinical presentations have been reported but rarely in the elderly population. We report a 71-year-old female patient with a 20-year history of an autoimmune disease who had recently become resistant to treatment. Her autoimmune symptoms significantly improved following resection of deeply seated bacterial infection in her paranasal sinuses. She was also diagnosed with cervical cancer. Clinicians should look carefully for hidden infections and/or malignancies in patients lacking response while on immunosuppressive therapy for autoimmune disease.

Microbiology, genomics, and clinical significance of the Pseudomonas fluorescens species complex, an unappreciated colonizer of humans

Pseudomonas fluorescens is not generally considered a bacterial pathogen in humans; however, multiple culture-based and culture-independent studies have identified it at low levels in the indigenous microbiota of various body sites. With recent advances in comparative genomics, many isolates originally identified as the "species" P. fluorescens are now being reclassified as novel Pseudomonas species within the P. fluorescens "species complex." Although most widely studied for its role in the soil and the rhizosphere, P. fluorescens possesses a number of functional traits that provide it with the capability to grow and thrive in mammalian hosts. While significantly less virulent than P. aeruginosa, P. fluorescens can cause bacteremia in humans, with most reported cases being attributable either to transfusion of contaminated blood products or to use of contaminated equipment associated with intravenous infusions. Although not suspected of being an etiologic agent of pulmonary disease, there are a number of reports identifying it in respiratory samples. There is also an intriguing association between P. fluorescens and human disease, in that approximately 50% of Crohn's disease patients develop serum antibodies to P. fluorescens. Altogether, these reports are beginning to highlight a far more common, intriguing, and potentially complex association between humans and P. fluorescens during health and disease.

The presence of fungal floras in sinuses in chronic sinusitis patients with polyps

Several fungal species are known to cause severe respiratory and cutaneous diseases. The aim of this work was to analyze the fungal flora in maxillary sinuses in patients suffering from chronic sinusitis with polyps. Twenty five patients (11 woman, 14 man) who underwent endoscopic surgical procedures were included into the study. During the operation, the smear from the maxillary sinus were obtained for the incubation. In 6 persons fungal floras was present.

[Endoscopic operations of the nose and paranasal sinuses in the own material]

INTRODUCTION

The aim of the study was to evaluate the results and 4-year own experience in the endoscopic treatment of the nose and paranasal sinuses.

MATERIAL AND METHODS

In the Clinic of Otolaryngology and Laryngological Oncology of the Medical University of Lodz between 2006 and 2009 there were 603 endoscopic operations performed on patients with chronic paranasal sinusitis, including 287 females aged 17-80 and 316 males aged 18-87. The patients were qualified for the operation on the basis of an interview, objective otorhinolaryngological examination, frontal and transverse computerized tomography of the nose and paranasal sinuses, laboratory tests (blood cell count, sedimentation tests, urine tests, electrolytes tests). Moreover, allergological diagnostics (skin prick tests, intranasal provocation tests), a histopathological examination of the removed lesions and a culture of biological material from the paranasal sinuses were done. The 0 degree and 30 degrees endoscopes of Storz GMBH and Wolf and the video rotation microtome (debrider).

RESULTS

Possible reasons for paranasal sinusitis were: viral infection (34.8%), anatomical disorders (28.5%), irritating factors like tobacco smoke (17.9%), allergy (13.4%), tumours (3.2%) and gastroesophageal reflux (2.1%). Finally, the following endoscopic operations were conducted: revision surgery of the maxillary sinuses in 680 cases (56.4%), ethmoidectomy in 586 cases (48.6%), polypectomy in 273 cases (22.6%), re-polypectomy in 232 cases (19.2%), sphenoid sinus revision in 229 cases (19.0%), frontal sinus revision in 80 cases (6.6%) and re-ethmoidectomy in 77 cases (6.4%). The average stay in the Clinic lasted 3.2 days.

CONCLUSIONS

Advantages of the complex surgical treatment are found in both post-operative and pharmacological procedures. The FESS surgery should be only a minimally invasive technique, which subsequently could guarantee an effective treatment, slight post-operative complications, a short hospitalization period and a quick return of the patient to work, as it is proved by the own study.