- The bacteriology of chronic sinusitis is less well-defined than acute sinusitis (typically due to Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis).
- A multifactorial disease that, aside from infection, is thought to result from genetics, environmental or occupational exposures, allergies, and immunodeficiencies.
- Typical respiratory pathogens may cause acute exacerbations of chronic sinusitis noted above.
- Polymicrobial flora is typically found if sinuses are cultured, especially in patients with a history of sinus surgeries, but the role of recovered organisms is often unclear.
- Controversy exists over the role of fungi in chronic sinusitis.
- The suggestion is that fungal elements may incite an eosinophil-mediated immune response in sinonasal mucosa.
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