| Objective By discussing the relationship between fungal allergen and fungal-related inflammatory diseases in the middle ear,it can provide theoretical support for prevention and treatment of these diseases.Method 1.A total of 21 cases of fungal infection with fungal otitis media(FOM)were enrolled in the experimental group,44 cases of fungal infection without fungal infection in the middle of the case as a control group.And analyze its clinical characteristics.2.Through the tympanic membrane and the middle ear mastoid cavity secretions for tablet / smear microscopy and fungal culture to identify pathogenic fungi.3.The patients were examined by pathologic examination to observe whether they had eosinophil infiltration.4.Combined with skin prick test,serum s Ig E test results further analysis and verification.Results The patients in the experimental group were examined by fungal smear microscopy and fungal identification.Major pathogenic fungi have: Aspergillus(7 cases,33.3%),Candida albicans(2 cases,9.5%),Trichophyton(1 cases,4.8%),Yeast(3 cases,14.3%),Penicillium(5 cases,23.8%),Alternaria alternata(3 cases,14.3%).(Tab 2,Fig 1-3)The results of fungal microscopy,culture and identification were consistent with those reported in the literature.Two groups of fungal allergen skin prick test positive were 9 cases,of which 6 cases in the experimental group,the control group 3 cases.The total positive rate of skin prick test in the experimental group and control group was 13.8%(9/65),the positive rate of fungal allergen skin prick test was 28.6%(6/21)in 21 experimental patients,the positive rate of fungal allergen skin prick test in 44 patients was 6.8%(3/44).(Tab 4)There was significant difference between the experimental group and the control group,χ2 = 3.963(corrected),p <0.05.The positive rate of fungal allergen in the experimental group was significantly higher than that in the control group.Suggesting that there are fungal-induced allergic reactions in both groups of patients,that is to say in the two groups of patients there are fungal-induced allergic reactions,and there are fungal infections in the experimental group there are fungal infections caused by the number of allergic patients more.These patients with fungal allergen skin prick test positive may be associated with fungal disease in the ear mastoid cavity.The experimental group of 21 patients with fungal allergen serum s Ig E positive test in 7 cases,accounting for 33.3% of the experimental group,accounting for 10.8% of the total cases;In the control group,4 cases of fungal allergen serum s Ig E positive in 44 patients,accounting for 9.1% of the control group,accounting for 6.2% of the total cases.There was significant difference in the positive rate of serum s Ig E detection between the experimental group and the control group χ2 = 4.343(corrected),p <0.05.(Tab 5)The positive rate of serum s Ig E in fungal allergen in the experimental group was significantly higher than that in the control group.There was a statistically significant difference in the positive rate of serum s Ig E between the two groups.Indicating that there is an allergic reaction caused by fungal allergens among the two groups of patients.And the incidence of allergic response induced by fungal allergen in the experimental group was significantly higher than that in the control group.In addition,the positive rate of serum s Ig E detection in fungal allergen was similar to that in fungal allergen skin prick test.So that more shows and verify that some patients are in the fungal allergen-induced allergenic state.In the experimental group,16 patients underwent surgical treatment.The postoperative examination was performed on the specimens of the middle ear mastoid lesions.Through the microscopic examination of the pathological specimens,8 of them showed eosinophil infiltration(Fig3),accounting for 50% of the pathologic examination in the experimental group;In the control group,31 patients underwent surgical treatment.The postoperative examination of the specimens of the middle ear mastoid lesions was performed.Through the microscopic examination of the pathological specimens,5 of them showed eosinophil infiltration,accounting for 16.1% of the pathologic examination in the control group.There was a statistically significant difference between the experimental group and the control group in the case of eosinophil infiltration in the pathologic examination,χ2 = 4.476(corrected),p <0.05.(Tab 6)The results suggest that there may be local allergens caused by fungal allergen.Conclusions 1 In inhalation allergens,fungal allergen is one of the most positive allergen.It can provide guidance for the diagnosis and treatment of clinical allergic diseases;2 In fungal-related inflammatory diseases in the middle ear,such as fungal otitis media and chronic suppurative otitis media with fungal infection,there is a fungal allergen caused by allergic reactions.This situation should be considered when diagnosing such diseases in clinical work;3 There may be one kind of allergic fungal otitis media caused by fungi of the allergen. |
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