The problem of endemic mycoses development and spread in modern conditions. Case report: aspergillosis of the maxillary sinus

Background. Endemic mycoses are an important cause of morbidity and mortality in immunocompromised individuals, but the issues of prevention, diagnosis and therapy remain incompletely resolved, when there is a high probability of this pathological condition atypical forms development. Local forms of mycosis can sometimes imitate other pathology, therefore, to verify the diagnosis, it is important to conduct a pathohistological examination using specific dyes. The objective of the study is to emphasize the relevance of the development and the risk of an increase in the number of cases of endemic mycoses in modern conditions, a review of a clinical case of aspergillosis of the maxillary sinus with a comparative analysis of the results of the conducted research with data from the world literature. Methods. The post-operative material of the patient with a diagnosis of chronic right-sided maxillary sinusitis with pronounced pain syndrome was examined in the study. The obtained sections of the lesion were stained with hematoxylin and eosin according to the standard method, as well as with the use of Schiff-iodic acid (PAS reaction) in order to identify the pathogenic factor. Results. The patient had complaints of discomfort, pain and periodic swelling in the area of ​​the right maxillary sinus in combination with mucous and purulent secretions from the nasal cavity and difficult nasal breathing for a year and a half. Fluctuations in blood glucose levels in the anamnesis. During computer tomography, a rounded dense formation with clear contours, up to 1.5 cm in diameter, was detected in the right maxillary sinus. During the operation, a dense formation of yellow-brown color, rounded shape, 1.7x1.5x1 cm in size was removed. According to the results of histopathological research among the tissue elements of the removed formation revealed various growth forms of Aspergillus. Conclusion. Cavities of the human body are a substrate for the development of invasive forms of mycosis, which require the early application of modern diagnostic methods in order to verify the diagnosis. The final diagnosis depends on the detection of fungi in smears of aspirate or biopsy material. To differentiate the type of fungal pathogen, it is better to use India ink or Schiff-iodic acid (PAS reaction). It is possible to assume that global climate changes, which are expected in the future, will lead to an increase in the insemination of the macroorganism by fungal flora.