ABSTRACT
This chapter introduces the basic science of fungal infections, and their laboratory identification, as well as providing a concise update on the subject of fungal infections in ENT. Specific tests are used to determine the causative agent of a fungal infection, and to guide the clinician towards appropriate treatment. Fungi with importance in otolaryngology typically belong to the divisions Ascomycota and Deuteromycota, divisions to which Aspergillus species and Candida species belong respectively. Rhinosporidiosis is an infectious disease caused by an aquatic protozoan previously considered to be a fungus. Typically patients presenting with allergic fungal rhinosinusitis (AFRS) are young, immunocompetent individuals, with a history of atopy or asthma. The most common causal fungal organisms are Aspergillus niger, Candida albicans, Actinomyces, Trichophyton, Aspergillus fumigatus and Candida tropicalis. Common predisposing factors include prolonged treatment with topical antibiotics, hearing aid use, regular swimming in contaminated water, trauma to the ear canal and immunosuppression.
