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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery

Indexed/Abstracted in: EMBASE, Scopus




Otorinolaringologia 2003 September;53(3):79-87

language: English

The microbiology and pathophysiology of infection in chronic rhinosinusitis

Bhattacharyya N.

Department of Otology and Laryngology Harvard Medical School Division of Otolaryngology Brigham and Women’s Hospital, Boston, MA, USA


Despite the prev­a­lence of chron­ic rhin­o­sin­u­sitis (CRS), its path­o­gen­e­sis ­remains rel­a­tive­ly poor­ly under­stood. Chronic infec­tion has ­been ­long ­thought to ­play a ­role in the path­o­gen­e­sis of CRS, but ­despite sophis­ti­cat­ed sur­gi­cal and cul­ture tech­niques, the lit­er­a­ture ­remains some­what incon­clu­sive on the ­true ­role of bac­te­ri­al infec­tion in CRS. In CRS, Staphlyococcal spe­cies pre­dom­i­nate. However, ­recent ­data ­also sug­gest ­that anaer­o­bic bac­te­ria and Gram-neg­a­tive bac­te­ria may be adopt­ing a ­more impor­tant ­role as caus­a­tive ­agents in bac­te­ri­al CRS. Such ­gram-neg­a­tive bac­te­ria are show­ing emerg­ing pat­terns of anti­bi­o­tic resis­tance. Similarly, fun­gi can be dem­on­strat­ed in the major­ity of ­patients suf­fer­ing ­from CRS, but ­they may ­also be iden­ti­fied in asymp­to­mat­ic con­trol ­patients. These ­data fur­ther com­pli­cate inter­pre­ta­tions of the ­role of fun­gi in the path­o­gen­e­sis of CRS. It is like­ly ­that bac­te­ri­al or fun­gal infec­tion is ­only ­part of a mul­ti­fac­to­ri­al path­o­gen­e­sis of CRS; as ­such, CRS is ­much ­more ­than sim­ply an infec­tious dis­or­der of the sinus­es. Awareness of the com­mon bac­te­ri­ol­o­gy of CRS is impor­tant in guid­ing empir­ic anti­bi­o­tic treat­ment and under­stand­ing med­i­cal and sur­gi­cal treat­ment fail­ures. However, ­more ­research is ­required ­into the micro­bi­ol­o­gy of CRS and the path­o­gen­ic ­role of infec­tious organ­isms in CRS.

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