ArticleFolia microbiologica2026
Deciphering the mycetoma 'grain': a comprehensive look at its chemical composition.
Article in Folia microbiologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Paranasal sinus mycetoma, also known as a fungus ball, is a non-invasive fungal infection characterized by a dense conglomeration of hyphae within a sinus cavity, most commonly the maxillary and sphenoid sinuses. Diagnosis is primarily based on the typical finding of hyperdensities on computed tomography, but their precise chemical composition remains incompletely understood. The objective of our study was to investigate the detailed chemical composition of central compartments of mycetomas (grains) and the relationship between these chemical components and clinical and radiological findings. This prospective cohort study (7/2023–7/2025) included 44 mycetoma samples from 41 patients. During functional endoscopic sinus surgery, grains mycetoma samples were collected for histopathological, microbiological, and chemical analyses using electron microscopy coupled with spectroscopy. The mucosal and mycotic samples underwent histopathological examination using haematoxylin-eosin staining, periodic acid–Schiff staining, and Grocott methenamine silver staining. Microbiological analysis involved fungal cultures on Sabouraud’s agar, which were evaluated by a specialist after 6–14 days of incubation. Analysis was performed on 44 mycetoma findings – 34 mycetoma in maxillary sinus, 7 in sphenoid sinus, 1 in ethmoids and 2 multiple localisations. Chemical analysis revealed the presence of inorganic compounds in 93.2% of the samples. The most prevalent component was calcium phosphate. Other compounds were also identified, including barium sulphate and zinc oxide. It was found that all samples containing sulphates were located exclusively in the maxillary sinus. Although this clinical correlation was not statistically significant (p = 0.522) due to the small sample size, it strongly supports a odontogenic ethology for maxillary mycetomas. This study confirms the complex chemical composition of mycetomas, which is responsible for their characteristic radiological appearance. Sulphates were exclusively identified within the maxillary sinus, providing further characterization of these mycetomas. Detailed chemical analysis, therefore, represents a valuable tool for understanding the pathogenesis of this condition.
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