[Classification of etiologic agents in fungal sinusitis by immunohistochemistry, histology and culture].

In the invasive forms of fungal sinusitis rapid identification of etiologic agent is of vital importance because of the different reaction of the fungi to various antifungal agents. In the non-invasive forms it is of interest for epidemiologic reasons and because of the potential transition to invasive and generalized mycoses in case of additional immunodeficiency. A diagnosis of fungal genus in histologic slides is desirable since up to 70% of the fungal cultures remain without result.In the present study 77 cases of fungal sinusitis were examined with the comercially available antibodies Anti-Aspergillus and Anti-Rhizomucor. The results of the histological examination and fungal cultures were added. The immunohistochemical examination permitted in 64 cases a classification as Aspergillus/Penicillium. Two cases caused by Zygomyzetes alone or in combination could be confirmed immunohistochemically. Four fungus balls showed no significant immunoreaction with both antibodies. If these where caused by other Hyphomycetes p.e. Pseudallescheria or if it where Aspergillus fungus balls that did not react because of extreme regressive change can not be decided.