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Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis
BACKGROUND: Mucormycosis necessitates rapid diagnosis and treatment. Microscopy and culture have been considered the gold standard for diagnosis but both take time of 3 - 5 days. KOH mount is another method for fungal identification that takes 1 - 2 h, but it has its own limitations. This study eval...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881490/ https://www.ncbi.nlm.nih.gov/pubmed/36755764 http://dx.doi.org/10.14740/jocmr4835 |
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author | Alam, Feroz Siddiqui, Bushra Hasan, Naba Arif, S.H. Maheshwari, Veena Alam, Kiran Hasan, Mahboob Khan, Roobina Khan, Parvez Anwer Ahmed, Aftab Gautam, Surabhi |
author_facet | Alam, Feroz Siddiqui, Bushra Hasan, Naba Arif, S.H. Maheshwari, Veena Alam, Kiran Hasan, Mahboob Khan, Roobina Khan, Parvez Anwer Ahmed, Aftab Gautam, Surabhi |
author_sort | Alam, Feroz |
collection | PubMed |
description | BACKGROUND: Mucormycosis necessitates rapid diagnosis and treatment. Microscopy and culture have been considered the gold standard for diagnosis but both take time of 3 - 5 days. KOH mount is another method for fungal identification that takes 1 - 2 h, but it has its own limitations. This study evaluated crush smear as a means of rapid cytological diagnosis. METHODS: Biopsy tissue (pre-treatment) from clinically suspicious mucormycosis patients (n = 52) was received in normal saline and crush/imprint smears were prepared; the remaining tissue was processed as routine biopsy specimen. After the rapid initial cytological identification, the patients were managed according to the standard clinical protocol. Random post-therapeutic biopsy samples of some of these patients (n = 19) were also obtained and again evaluated cytologically. RESULTS: Crush smears showed sensitivity/specificity of 77.7%/75.0% with histopathology and 72.2%/62.5% with culture, respectively, while KOH mount had values of 71.4%/70.5% with histopathology and 79.3%/69.5% with culture, respectively. Degenerative fungal morphological characteristics and cellular inflammatory infiltrate (predominantly neutrophilic) in the vicinity of fungal hyphae were compared in pre- and post-treatment groups, and we found a statistically significant difference (P < 0.05) between them. CONCLUSION: Our preliminary results suggest that crush smear cytology is a simple, rapid, cost-effective and easily available method for diagnosing mucormycosis. Moreover, crush smears also demonstrated morphological alteration in hyphal structure and accompanying immune cell infiltration which may provide valuable insights into mechanism of therapy/host immune response against fungal pathogen. |
format | Online Article Text |
id | pubmed-9881490 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-98814902023-02-07 Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis Alam, Feroz Siddiqui, Bushra Hasan, Naba Arif, S.H. Maheshwari, Veena Alam, Kiran Hasan, Mahboob Khan, Roobina Khan, Parvez Anwer Ahmed, Aftab Gautam, Surabhi J Clin Med Res Original Article BACKGROUND: Mucormycosis necessitates rapid diagnosis and treatment. Microscopy and culture have been considered the gold standard for diagnosis but both take time of 3 - 5 days. KOH mount is another method for fungal identification that takes 1 - 2 h, but it has its own limitations. This study evaluated crush smear as a means of rapid cytological diagnosis. METHODS: Biopsy tissue (pre-treatment) from clinically suspicious mucormycosis patients (n = 52) was received in normal saline and crush/imprint smears were prepared; the remaining tissue was processed as routine biopsy specimen. After the rapid initial cytological identification, the patients were managed according to the standard clinical protocol. Random post-therapeutic biopsy samples of some of these patients (n = 19) were also obtained and again evaluated cytologically. RESULTS: Crush smears showed sensitivity/specificity of 77.7%/75.0% with histopathology and 72.2%/62.5% with culture, respectively, while KOH mount had values of 71.4%/70.5% with histopathology and 79.3%/69.5% with culture, respectively. Degenerative fungal morphological characteristics and cellular inflammatory infiltrate (predominantly neutrophilic) in the vicinity of fungal hyphae were compared in pre- and post-treatment groups, and we found a statistically significant difference (P < 0.05) between them. CONCLUSION: Our preliminary results suggest that crush smear cytology is a simple, rapid, cost-effective and easily available method for diagnosing mucormycosis. Moreover, crush smears also demonstrated morphological alteration in hyphal structure and accompanying immune cell infiltration which may provide valuable insights into mechanism of therapy/host immune response against fungal pathogen. Elmer Press 2023-01 2023-01-24 /pmc/articles/PMC9881490/ /pubmed/36755764 http://dx.doi.org/10.14740/jocmr4835 Text en Copyright 2023, Alam et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Alam, Feroz Siddiqui, Bushra Hasan, Naba Arif, S.H. Maheshwari, Veena Alam, Kiran Hasan, Mahboob Khan, Roobina Khan, Parvez Anwer Ahmed, Aftab Gautam, Surabhi Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title | Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title_full | Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title_fullStr | Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title_full_unstemmed | Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title_short | Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis |
title_sort | rapid cytological diagnosis with evaluation of pre- and post-therapeutic fungal morphological characteristics in mucormycosis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881490/ https://www.ncbi.nlm.nih.gov/pubmed/36755764 http://dx.doi.org/10.14740/jocmr4835 |
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