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Topic:Fungal

Fungal infections in horses encompass a variety of conditions caused by different fungal species that can affect the skin, respiratory system, and other body systems. These infections can range from superficial skin infections, such as ringworm, to more serious systemic infections like aspergillosis. The presence of fungi in the equine environment and their interactions with the horse's immune system can influence the development and severity of these infections. Diagnosis often involves identifying the specific fungal organism through laboratory testing, while treatment may include antifungal medications and supportive care. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, diagnosis, and treatment of fungal infections in horses.
Equine deep stromal abscesses (51 cases – 2004-2009)–Part 2: the histopathology and immunohistochemical aspect with attention to the histopathologic diagnosis, vascular response, and infectious agents.
Veterinary ophthalmology    October 17, 2013   Volume 17 Suppl 1 14-22 doi: 10.1111/vop.12102
de Linde Henriksen M, Andersen PH, Mietelka K, Farina L, Thomsen PD, Plummer CE, Mangan BG, Heegaard S, Coleman JK, Toft N, Brooks DE.To investigate histopathologic and immunohistochemical aspects of equine deep stromal abscesses (DSA) with a focus on the histopathologic diagnosis, presumptive etiology, and the immunohistochemical expression of three angiogenesis-related factors: vascular endothelial growth factor-A (VEGF-A), pigment epithelium-derived factor (PEDF), and interleukin-1 receptor antagonist (IL-1ra). Methods: Paraffin-embedded biopsy samples from 51 DSA. The biopsies were collected from full-thickness penetrating keratoplasty or split-thickness lamellar keratoplasty surgeries at the University of Florida Veteri...
Candida osteomyelitis in a gelding.
The Canadian veterinary journal = La revue veterinaire canadienne    August 2, 2013   Volume 54, Issue 2 176-178 
Doyle A, López A, Pack L, Muckle A.A 2-year-old gelding was referred for evaluation of severe right forelimb lameness. The horse was grade 4/5 lame on the right forelimb. Clinical, laboratory, and radiographic findings were consistent with septic arthritis and osteomyelitis. Due to poor prognosis the owner elected euthanasia. Histopathology confirmed chronic arthritis and osteomyelitis with intralesional yeast (Candida species). Ostéomyélite àCandidachez un hongre. Un hongre âgé de 2 ans a été référé pour l’évaluation d’une boiterie grave du membre antérieur droit. Le cheval avait une boiterie de stade 4/5 du me...
Evaluation of the conjunctival fungal flora and its susceptibility to antifungal agents in healthy horses in Switzerland.
Veterinary ophthalmology    August 2, 2013   Volume 17 Suppl 1 31-36 doi: 10.1111/vop.12088
Voelter-Ratson K, Monod M, Unger L, Spiess BM, Pot SA.To characterize the conjunctival fungal flora and to determine the susceptibility of 2 isolated molds to antifungal drugs in samples of 64 healthy horses from The National Stud in Switzerland. Methods: Conjunctival cytobrush samples were collected from both eyes of 64 ophthalmologically normal horses in August 2012 and subsequently cultured on Sabouraud's agar medium. Growing fungi were identified and counted. Etests or broth microdilution tests for Aspergillus fumigatus and Eurotium amstelodami were carried out to determine antifungal drug sensitivity. These species had previously been detect...
Dysphagia caused by focal guttural pouch mycosis: mononeuropathy of the pharyngeal ramus of the vagal nerve in a 20-year-old pony mare.
Irish veterinary journal    July 11, 2013   Volume 66, Issue 1 13 doi: 10.1186/2046-0481-66-13
Eichentopf A, Snyder A, Recknagel S, Uhlig A, Waltl V, Schusser GF.A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the ...
Species of Candida as a component of the nasal microbiota of healthy horses.
Medical mycology    May 8, 2013   Volume 51, Issue 7 731-736 doi: 10.3109/13693786.2013.777858
Cordeiro Rde A, Bittencourt PV, Brilhante RS, Teixeira CE, Castelo-Branco Dde S, Silva ST, De Alencar LP, Souza ER, Bandeira Tde J, Monteiro AJ....Respiratory infections are a common problem among equines and occur with variable rates of morbidity and mortality. Although some fungal species are considered primary agents of respiratory tract infections in several mammals, their relevance in respiratory diseases of equines is frequently neglected. In the present study, we performed an active search for Candida spp. in the nasal cavity of horses. The presence of Candida spp. was investigated through the use of nasal swabs that were streaked on culture media. These yeasts were identified through physiological testing and their in vitro antif...
Furry pet allergens, fungal DNA and microbial volatile organic compounds (MVOCs) in the commercial aircraft cabin environment.
Environmental science. Processes & impacts    May 7, 2013   Volume 15, Issue 6 1228-1234 doi: 10.1039/c3em30928b
Fu X, Lindgren T, Guo M, Cai GH, Lundgren H, Norbäck D.There has been concern about the cabin environment in commercial aircraft. We measured cat, dog and horse allergens and fungal DNA in cabin dust and microbial volatile organic compounds (MVOCs) in cabin air. Samples were collected from two European airline companies, one with cabins having textile seats (TSC) and the other with cabins having leather seats (LSC), 9 airplanes from each company. Dust was vacuumed from seats and floors in the flight deck and different parts of the cabin. Cat (Fel d1), dog (Can f1) and horse allergens (Equ cx) were analyzed by ELISA. Five sequences of fungal DNA we...
Clinical and molecular epidemiology of veterinary blastomycosis in Wisconsin.
BMC veterinary research    April 22, 2013   Volume 9 84 doi: 10.1186/1746-6148-9-84
Anderson JL, Sloss BL, Meece JK.Several studies have shown that Blastomyces dermatitidis, the etiologic agent of blastomycosis, is a genetically diverse pathogen. Blastomycosis is a significant health issue in humans and other mammals. Veterinary and human isolates matched with epidemiological case data from the same geographic area and time period were used to determine: (i) if differences in genetic diversity and structure exist between clinical veterinary and human isolates of B. dermatitidis and (ii) if comparable epidemiologic features differ among veterinary and human blastomycosis cases. Results: Genetic typing of 301...
Corneal ulcers in horses.
Compendium (Yardley, PA)    March 28, 2013   Volume 35, Issue 1 E4 
Williams LB, Pinard CL.Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems all...
Equine keratomycosis in Switzerland: a retrospective evaluation of 35 horses (January 2000-August 2011).
Equine veterinary journal    March 12, 2013   Volume 45, Issue 5 608-612 doi: 10.1111/evj.12042
Voelter-Ratson K, Pot SA, Florin M, Spiess BM.Keratomycosis is a severe disease in horses. Geographical differences in fungi causing keratomycosis and susceptibility of the organisms to antifungal drugs exist but few previous publications on this disease originate from Europe. Objective: To retrospectively compare the clinical data of 36 eyes with keratomycosis, diagnosed in 35 horses between January 2000 and August 2011 at the Vetsuisse Faculty of Switzerland. Case history, season, prior treatment, clinical appearance, surgical and medical treatment, treatment duration, and globe survival were evaluated. Methods: Retrospective case serie...
Retrospective study on equine uterine fungal isolates and antifungal susceptibility patterns (1999-2011).
Equine veterinary journal. Supplement    March 2, 2013   Issue 43 84-87 doi: 10.1111/j.2042-3306.2012.00608.x
Beltaire KA, Cheong SH, Coutinho da Silva MA.Knowledge of commonly encountered fungi infecting the mare's reproductive tract and their respective drug susceptibilities should improve treatment efficacy in mares with fungal endometritis. This is particularly important when practitioners need to start empiric treatment before culture results are complete. Objective: To report the spectrum of fungal isolates from uterine samples from mares with reproductive problems and their respective antifungal susceptibilities. Methods: Equine uterine samples submitted to the Cornell University Animal Health Diagnostic Centre for fungal culture between ...
Fungal diseases of horses.
Veterinary microbiology    January 29, 2013   Volume 167, Issue 1-2 215-234 doi: 10.1016/j.vetmic.2013.01.015
Cafarchia C, Figueredo LA, Otranto D.Among diseases of horses caused by fungi (=mycoses), dermatophytosis, cryptococcosis and aspergillosis are of particular concern, due their worldwide diffusion and, for some of them, zoonotic potential. Conversely, other mycoses such as subcutaneous (i.e., pythiosis and mycetoma) or deep mycoses (i.e., blastomycosis and coccidioidomycosis) are rare, and/or limited to restricted geographical areas. Generally, subcutaneous and deep mycoses are chronic and progressive diseases; clinical signs include extensive, painful lesions (not pathognomonic), which resemble to other microbial infections. In ...
Development of a broad-range quantitative polymerase chain reaction assay to detect and identify fungal DNA in equine endometrial samples.
American journal of veterinary research    December 29, 2012   Volume 74, Issue 1 161-165 doi: 10.2460/ajvr.74.1.161
Ferris RA, Dern K, Veir JK, Hawley JR, Lappin MR, McCue PM.To develop a broad-range 28S ribosomal DNA quantitative PCR (qPCR) assay for detection of fungal DNA in equine endometrial samples. Methods: 12 fungal samples from a clinical diagnostic laboratory and 29 samples obtained from 17 mares. Methods: The qPCR assay was optimized with commercially acquired fungal organisms and validated with samples obtained from the clinical diagnostic laboratory. Subsequently, 29 samples from 17 mares suspected of having fungal endometritis were evaluated via the qPCR assay and via traditional fungal culture and endometrial cytology. Amplicons from the qPCR assay w...
Capacity for colonization and degradation of horse manure and wheat-straw-based compost by different strains of Agaricus subrufescens during the first two weeks of cultivation.
Bioresource technology    December 29, 2012   Volume 131 266-273 doi: 10.1016/j.biortech.2012.12.141
Farnet AM, Qasemian L, Peter-Valence F, Ruaudel F, Savoie JM, Ferré E.The potential of Agaricus subrufescens strains to colonize and transform horse manure and wheat-straw-based mushroom compost under the physico-chemical conditions typically used for Agaricus bisporus was assessed. Lignocellulolytic activities, H2O2 production and substrate transformation (assessed via CP/MAS NMR of (13)C) for certain A. subrufescens strains were similar or even greater than those obtained for an A. bisporus strain used as control. Moreover, the functional diversity of the microbial communities of the substrate was not altered by the growth of A. subrufescens after 2weeks. Thes...
Coadministration of sodium alginate pellets containing the fungi Duddingtonia flagrans and Monacrosporium thaumasium on cyathostomin infective larvae after passing through the gastrointestinal tract of horses.
Research in veterinary science    December 27, 2012   Volume 94, Issue 3 568-572 doi: 10.1016/j.rvsc.2012.11.011
Tavela Ade O, de Araújo JV, Braga FR, da Silveira WF, Dornelas e Silva VH, Carretta Júnior M, Borges LA, Araujo JM, Benjamin Ldos A, Carvalho GR....The predatory nematophagous fungi have been used as an alternative control of gastrointestinal nematodes of domestic animals in natural and laboratory conditions. However, it is unclear if the association of some of these species could bring some kind of advantage, from a biological standpoint. In this context, this study consisted of two tests in vitro: in assay A, the assessment of the viability of the association of pellets in sodium alginate matrix containing the fungus Duddingtonia flagrans (AC001) and Monacrosporium thaumasium (NF34) and its predatory activity on infective larvae (L3) of...
Fungal polymerase chain reaction testing in equine ulcerative keratitis.
Veterinary ophthalmology    December 10, 2012   Volume 16, Issue 5 341-351 doi: 10.1111/vop.12004
Zeiss C, Neaderland M, Yang FC, Terwilliger G, Compton S.To assess the diagnostic utility of fungal polymerase chain reaction (PCR) in forty-three horses with naturally acquired corneal ulcers presenting to a private practice. Methods: Routine evaluation of cytologic, histologic, and microbiologic samples was performed. Two PCR approaches were compared - generic and specific fungal nested PCR followed by sequencing and quantitative PCR (qPCR). PCRs were applied to pure control fungal cultures, corneal tissue from ulcerated eyes and in a subset of 9 horses, to swabs from contralateral normal eyes. Results: The expected fungus was identified by nested...
Relationship of mixed bacterial infection to prognosis in foals with pneumonia caused by Rhodococcus equi.
Journal of veterinary internal medicine    November 1, 2012   Volume 26, Issue 6 1443-1448 doi: 10.1111/j.1939-1676.2012.01023.x
Giguère S, Jordan LM, Glass K, Cohen ND.Isolation of multiple bacterial species is common in foals with Rhodococcus equi pneumonia. Objective: There is no association between isolation of other microorganisms and outcome. Methods: 155 foals with pneumonia caused by R. equi. Methods: Case records of foals diagnosed with R. equi pneumonia based on culture of the respiratory tract were reviewed at 2 referral hospitals (University of Florida [UF] and Texas A&M University [TAMU]). Results: R. equi was cultured from a tracheobronchial aspirate (TBA) in 115 foals and from lung tissue in 38 foals. Survival was significantly higher at UF...
Equine keratomycoses in California from 1987 to 2010 (47 cases).
Equine veterinary journal    September 4, 2012   Volume 45, Issue 3 361-366 doi: 10.1111/j.2042-3306.2012.00623.x
Reed Z, Thomasy SM, Good KL, Maggs DJ, Magdesian KG, Pusterla N, Hollingsworth SR.Equine keratomycosis in the western USA has received little study, probably owing to its low prevalence. Objective: To determine clinical features, predominant fungal isolates, treatment modalities and outcomes of horses with keratomycosis in California and compare these with results from different geographic regions. Methods: Records of horses presented to the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) with confirmed keratomycosis between 1987 and 2010 were reviewed for this retrospective study. Information retrieved from the record included background, oph...
Subclinical fungal endometritis in an 8-year-old Hanoverian mare.
The Canadian veterinary journal = La revue veterinaire canadienne    August 2, 2012   Volume 53, Issue 2 196-198 
Aitken GJ.Clinical and subclinical endometritis are leading causes of reduced reproductive efficiency in the mare. Clinical endometritis is relatively easy to diagnose during routine physical and ultrasonographic reproductive examinations, whereas the diagnosis of subclinical endometritis requires a more detailed work-up. The goal of this paper is to review the various options, and describe the regimen chosen in a mare with subclinical fungal endometritis. Endométrite fongique subclinique chez une jument hanovrienne âgée de 8 ans. L’endométrite clinique et subclinique sont les principales causes d...
Mycotic encephalitis, sinus osteomyelitis, and guttural pouch mycosis in a 3-year-old Arabian colt.
The Canadian veterinary journal = La revue veterinaire canadienne    June 2, 2012   Volume 52, Issue 12 1339-1341 
Hunter B, Nation PN.Mycotic encephalitis caused severe ataxia and other neurologic deficits in a horse. The finding of a single, large focus of cerebral malacia, with histopathologic evidence of fungal elements, suggested infection was a result of direct transfer from the frontal sinuses, rather than hematogenous spread from the guttural pouch. Une encéphalite mycotique a causé une ataxie grave et d’autres déficits neurologiques chez un cheval. La découverte d’un grand foyer unique de malacie cérébrale avec une preuve histopathologique d’éléments fongiques a suggéré que l’infection était un tr...
Equine subepithelial keratomycosis.
Veterinary ophthalmology    May 14, 2012   Volume 16, Issue 2 93-96 doi: 10.1111/j.1463-5224.2012.01031.x
Brooks DE, Plummer CE, Mangan BG, Ben-Shlomo G.To describe clinical findings in equine subepithelial keratomycosis (SEK). Methods: Retrospective medical records study. Methods: Medical records of horses that had subepithelial keratomycosis (SEK) at the University of Florida Veterinary Medical Center from 2007 to 2011 were reviewed. Methods: Data collected from the medical records included signalment, clinical descriptions of ocular lesions, diagnostic techniques, and therapeutic outcomes. Results: Twenty-one horses, consisting of three Quarter horse geldings, two Morgan geldings, one Morgan mare, two Arabian mares, three Arabian geldings, ...
Structural elucidation of phase I and II metabolites of bupivacaine in horse urine and fungi of the Cunninghamella species using liquid chromatography/multi-stage mass spectrometry.
Rapid communications in mass spectrometry : RCM    May 5, 2012   Volume 26, Issue 11 1338-1346 doi: 10.1002/rcm.6225
Rydevik A, Bondesson U, Hedeland M.Bupivacaine is a local anaesthetic prohibited in equine sports. It is highly metabolized in the horse but a thorough description of its metabolite profile is lacking. An administration study should find appropriate analytical targets for doping control. Furthermore, knowledge of an in vitro system for production of metabolites would be beneficial. Methods: Marcain® (bupivacaine hydrochloride) was administered subcutaneously to a horse and urine samples were collected. In vitro metabolic systems consisting of the fungi Cunninghamella elegans and Cunninghamella blakesleeana were incubated with ...
Guttural pouch mycosis in six horses in New Zealand.
New Zealand veterinary journal    April 7, 2012   Volume 60, Issue 3 203-209 doi: 10.1080/00480169.2011.648891
Archer RM, Knight CG, Bishop WJ.Six horses from several geographical locations in New Zealand presented with signs of guttural pouch mycosis. All horses had experienced epistaxis within 14 days of presentation. Results: In five horses with epistaxis, a diagnosis of guttural pouch mycosis was made on endoscopic observation of fungal plaques in the affected guttural pouches. One of these cases died before surgery was attempted. The remaining four cases underwent ligation and balloon catheter occlusion of the internal carotid artery of the affected pouch. Three of these horses survived and were reported to be healthy 1 year aft...
Optimal management of equine keratomycosis.
Veterinary medicine (Auckland, N.Z.)    March 12, 2012   Volume 3 7-17 doi: 10.2147/VMRR.S25013
Galera PD, Brooks DE.Keratomycosis in the horse exists in several unique clinical forms. This paper discusses the diagnosis and clinical management of keratomycosis in the horse associated with tear film instability, epithelial keratopathy, subepithelial infiltrates, superficial and deep ulcers, plaques, melting ulcers, descemetoceles, iris prolapse, and stromal abscesses. Prompt diagnosis and aggressive treatment of equine keratomycosis can make a major difference in the maintenance of a cosmetic and visual eye.
Occurrence of pathogenic fungi to Amblyomma cajennense in a rural area of Central Brazil and their activities against vectors of Rocky Mountain spotted fever.
Veterinary parasitology    March 1, 2012   Volume 188, Issue 1-2 156-159 doi: 10.1016/j.vetpar.2012.02.016
D'Alessandro WB, Humber RA, Luz C.Two isolates of Beauveria bassiana and one of Purpureocillium lilacinum (=Paecilomyces lilacinus) were found infecting Amblyomma cajennense engorged females collected on horses (0.15% infection rate from a total of 1982 specimens) and another two isolates of P. lilacinum and one Metarhizium anisopliae detected in soils (2.1% from 144 samples) collected in typical pasture habitats of this tick in Central Brazil from October 2009 to March 2011. Fungi were isolated from soils with Rhipicephalus sanguineus as surrogate baits. No fungi were found in ticks or soils during the driest months (May to A...
Equine keratomycosis in Japan.
Veterinary ophthalmology    February 28, 2012   Volume 16, Issue 1 1-9 doi: 10.1111/j.1463-5224.2012.01004.x
Wada S, Hobo S, Ode H, Niwa H, Moriyama H.To describe the incidence, clinical progress, visual outcome, and laboratory findings of equine keratomycosis in Japan. Methods:  Retrospective study of the medical records of horses clinically and mycologically diagnosed with keratomycosis at the Equine Hospitals of the Japan Racing Association from 2005 to 2011. Results: The diagnosis of keratomycosis was confirmed in eight horses (40.0% of the 20 horses with infectious keratitis from which fungi and/or bacteria were isolated). Fungi recovered from corneal swabs were identified as Aspergillus flavus (4), Aspergillus niger (1), Fusarium sol...
Meningitis and meningoencephalomyelitis in horses: 28 cases (1985-2010).
Journal of the American Veterinary Medical Association    February 16, 2012   Volume 240, Issue 5 580-587 doi: 10.2460/javma.240.5.580
Toth B, Aleman M, Nogradi N, Madigan JE.To describe clinical and clinicopathologic findings and outcome of horses with meningitis and meningoencephalomyelitis. Methods: Retrospective case series. Methods: 28 horses. Methods: Medical records of horses admitted to the hospital during a 25-year period were reviewed. Horses with a definitive diagnosis of meningitis or meningoencephalomyelitis were included in this study. Information extracted from the medical records included signalment, history, reason for admission, clinical signs, results of clinicopathologic testing and diagnostic procedures, treatment, outcome, and necropsy finding...
How to improve the hygienic quality of forages for horse feeding.
Journal of the science of food and agriculture    October 17, 2011   Volume 92, Issue 4 975-986 doi: 10.1002/jsfa.4680
Séguin V, Garon D, Lemauviel-Lavenant S, Lanier C, Bouchart V, Gallard Y, Blanchet B, Diquélou S, Personeni E, Ourry A.Improving the hygienic quality of forages for horse nutrition seems to be a reasonable target for decreasing the prevalence of pulmonary diseases. The aim of the experiment was to study the effects of different agricultural practices on the main aero-allergens contained in forages, including breathable dust, fungi, mycotoxins and pollens. Results: Results showed that the late harvest of hay, a second crop or a haylage production provides a good alternative to increase hygienic quality by reducing fungi contamination and breathable dust content. Barn drying of hay, while having no effect on bre...
Brittle tail syndrome is an emerging infection in horses caused by a keratinolytic fungus Equicapillimyces hongkongensis gen. nov., sp. nov.
Veterinary microbiology    October 1, 2011   Volume 155, Issue 2-4 399-408 doi: 10.1016/j.vetmic.2011.09.024
Wong SS, Ngan AH, Riggs CM, Teng JL, Choi GK, Poon RW, Hui JJ, Low FJ, Luk A, Yuen KY.The newly described brittle tail syndrome causes weakening and breakage of the tail hair of horses. Extensive mycological and molecular studies showed that a novel fungus Equicapillimyces hongkongensis gen. nov., sp. nov. is the most likely cause of this syndrome. It is a septate branching hyaline mould which grows optimally at 30°C, requires nicotinic acid but is inhibited by cycloheximide, and specifically infects horse hair. Hyphae fill the core of infected hair shafts with short-necked structures resembling ascomata containing banana-shaped septate ascospore-like structures perforating th...
Fungal microbiota from ocular conjuctiva of clinically healthy horses belonging to the military police cavalry of alagoas.
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]    September 1, 2011   Volume 42, Issue 3 1151-1155 doi: 10.1590/S1517-838220110003000038
de Sousa ME, Araújo MA, Mota RA, Porto WJ, Souza AK, Dos Santos JL, da Silva PP.Normal fungal conjunctiva microbiota of horses remains stable in healthy animals, free from ocular and/or systemic diseases which may, eventually, cause ocular alterations. The knowledge of the fungal microbiota is of great importance due to the reduced number of studies reported in the literature and also to the large occurrence of ocular alterations, mainly keratomycosis, in these animals. The aim of this study was to isolate and to identify the fungi present in the ocular conjunctiva of healthy horses belonging to the Military Police Cavalry of Alagoas. Samples from both conjunctival sacks ...
Paranasal sinus disease in horses.
Compendium (Yardley, PA)    August 27, 2011   Volume 33, Issue 2 E2 
Waguespack RW, Taintor J.The paranasal sinus system of horses is complex, comprising six pairs of sinuses. Disease processes that can develop in the sinuses include ethmoid hematomas, cysts, neoplasia, and bacterial and fungal infections. Horses that develop paranasal sinus disease vary widely in age. A significant number of clinical conditions involving the paranasal sinuses require a combination of diagnostic tests to determine the specific pathologic process. Because of the anatomic location of the paranasal sinuses and associated chronic conditions that affect many patients, many disease processes involving the pa...
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