Nasal fungi in newborn babies sheds light on eosinophilic chronic sinusitis

Researchers have recently claimed that eosinophilic chronic sinusitis is an immune disorder caused by the body’s reaction to fungus. It is common for airborne fungi to lodge in the mucus lining of the sinuses without causing problems. But in individuals prone to chronic sinusitis, this initiates an immune response, which causes the body to attack the fungi, leading to damage of the sinus membranes and full-blown symptoms of chronic sinusitis.

Follow-on studies demonstrated that positive fungal cultures grew out of the nasal mucus of nine of ten of individuals both with and without chronic rhinosinusitis. These findings lead experts to believe that the presence of nasal fungi is common within the adult population. However, little is known about the point or age when fungi become present in the nasal mucus of humans.

A team of Austrian ear, nose, and throat specialists attempted to ascertain when fungi appeared in the nasal mucus of neonates. The authors of “Fungi – A Normal Content of Human Nasal Mucus” are Andreas Lackner MD., Heinz Stammberger M.D. Kurt Freudenschuss MD, Walter Buzina PhD, MD, and Hannes Braun MD, all from the Medical University Graz, Auenbruggerplatz COSM Spring Meeting ARS,1/5/2004 Phoenix, AZ. Their findings are being presented at the 107th meeting of the American Rhinologic Society http://www.american-rhinologic.org/ , being held April 30 - May 3, 2004, at the JW Marriott Desert Ridge Resort & Spa, Phoenix, AZ.

Methodology: The researchers examined nasal mucus from 30 neonates immediately after birth, on the first and fourth day post partum, and after two and four months of life. The samples obtained with sterile cotton swabs were cultured on agar plates. Fungal cultures were identified either conventionally by microscopy or with molecular techniques. To prove possible contamination during birth, mucus of the maternal birth canal was examined as well.

Results: Positive fungal cultures were found in six of 30 (20 percent) of the neonates, three of them with Candida albicans, or thrush fungus, most likely due to passing the maternal birth canal. In two of 29 (seven percent neonates, positive fungal cultures were obtained on the first day post partum on the fourth day, four of 26 (15 percent) were all limited to one day only and without clinical symptoms of colonization.

After the second month of life, examination of nasal mucus yielded positive fungal cultures in eight of 11 (72 percent); after four months, 17 of 18 infants were found to have a wide range of fungi present.

Conclusions: These findings suggest that fungi can be cultured from nasal mucus as soon as contact with the environmental air exists but yeasts and molds (fungi) are not persistent in the first days of life. However, after four months of life, prevalence of fungi in newborns is similar to that found in adults. Accordingly, from an early age fungal cultures can be obtained from almost everyone’s nose. Therefore fungi must be considered a normal content of nasal mucus, where they are “on transit”.