Our working group is committed to advancing the understanding and treatment of fungal sinusitis through collaborative research and clinical expertise. Our primary objectives include the assessing of the prevalence of fungal rhinosinusitis (FRS), development of novel diagnostic tools, enhancement of therapeutic strategies, and the improvement of patient outcomes. By fostering interdisciplinary dialogue and advocating for evidence-based practices in fungal sinusitis management, we aim to set new standards in healthcare. Our ambition is to contribute significantly to the field, ultimately leading to more effective treatments and better quality of life for patients suffering from fungal sinusitis.
We investigated mucormycosis caused by Rhizopus homothallicus (n=43). The mean age of patients was 51.6 years and 66.8% were males. The significant comorbidities were predominantly diabetes (93.9%) and diabetic ketoacidosis (16.1%). Comparing 41 cases of R. homothallicus-associated rhino-orbital mucormycosis (ROM) with 266 cases of Rhizopus arrhizus, we found a notably lower 30-day mortality rate with R. homothallicus (9.8% vs. 39.1% for R. arrhizus). Multivariate analysis highlighted that R. homothallicus infection and ROM surgery correlated independently with reduced mortality. Antifungal susceptibility testing indicated low minimum inhibitory concentrations (MICs) for R. homothallicus. Genetic analysis revealed distinct strain clustering.
Furthermore, we developed an in-house ELISA using R. arrhizus antigens to detect anti-Rhizopus antibodies (IgG and IgM) in mucormycosis patients’ sera. This assay, validated on 95 subjects (55 mucormycosis patients, 24 with other fungal infections, and 16 healthy controls), demonstrated high sensitivity (83.6-92.7% for IgG; 72.7-87.3% for IgM) and specificity (91.7-92.5% for IgG; 80-82.5% for IgM). IgG-based ELISA proved superior in diagnosing rhino-orbital mucormycosis (84.6%) and pulmonary cases (86.6%) compared to IgM-based assays.
We performed surveillance nasal endoscopy and nasal tissue sampling for fungal culture in fifty-three high-risk patients during the third to fifth week of the onset of COVID-19 symptoms and treatment. It was concluded that nasal endoscopic-guided tissue sampling for fungal culture serves as a valuable surveillance tool for predicting ROM in COVID-19 patients.
In 2024-2025, the ABPA working group plans to disseminate the revised ISHAM-ABPA working group guidelines.
None.