{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:46:40Z","timestamp":1789987600763,"version":"4.0.1"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,2,2]],"date-time":"2012-02-02T00:00:00Z","timestamp":1328140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Atypical mycobacterium (AM) involvement in refractory chronic rhinosinusitis (CRS) is sought by some surgeons with customary acid\u2010fast bacilli cultures (AFBC) in the operating room (OR). We evaluate our experience with AM in CRS by describing (1) associated risk factors, (2) species identified, and (3) frequency of positive cultures in clinic versus OR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary rhinology practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>AFBC taken between 2005 and 2011 were identified from a microbiology laboratory database. Charts were reviewed for gender, age, medical history, risk factors for AM, pathogen types, and treatments, with statistical comparison using Pearson \u03c7<jats:sup>2<\/jats:sup>. The benefit of \u201ctargeted AFBC\u201d for cases with high clinical suspicion was compared with \u201ccustomary AFBC\u201d in the OR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010seven patients were identified with AM, of which 10 had one or more risk factors for AM including foreign body (n = 4), non\u2010HIV immune dysfunction (n = 4), and previous chemoradiation (n = 4). Six different AM species were identified: most frequently <jats:italic>Mycobacterium abscessus<\/jats:italic> (57.1%), followed by <jats:italic>Mycobacterium avium\u2010intracellulare<\/jats:italic> complex (14.3%) and <jats:italic>Mycobacterium chelonae<\/jats:italic> (14.3%). \u201cTargeted AFBC\u201d from the outpatient setting were positive in 10 of 190 (5.3%) patients, whereas 10 of 373 (2.6%) patients of \u201ccustomary AFBC\u201d in the OR were positive (<jats:italic>P<\/jats:italic> =. 12). Macrolide therapy was employed in 23 of 37 (62%) patients with AM\u2010associated CRS but was not prescribed in patients with positive \u201ccustomary AFBC\u201d alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>AM\u2010associated CRS is an uncommon condition that can occur in the absence of foreign body or overtly altered innate\/adaptive immunity. Indications and efficacy of macrolide therapy, as well as the potential relationships between existence of AM in tap water, AM biofilms, and frequent use of nasal irrigations warrant further investigation in refractory CRS.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599812437333","type":"journal-article","created":{"date-parts":[[2012,2,3]],"date-time":"2012-02-03T20:31:12Z","timestamp":1328301072000},"page":"1012-1016","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Atypical Mycobacterium Detection in Refractory Chronic Rhinosinusitis"],"prefix":"10.1002","volume":"146","author":[{"given":"Alla","family":"Solyar","sequence":"first","affiliation":[{"name":"Coastal Ear, Nose and Throat Neptune New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Lahey Clinic Burlington Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Przybyszewski","sequence":"additional","affiliation":[{"name":"Baycare Laboratories St Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald C.","family":"Lanza","sequence":"additional","affiliation":[{"name":"Sinus &amp; Nasal Institute of Florida St Petersburg Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,2,2]]},"reference":[{"key":"e_1_2_7_2_2","unstructured":"KuhlmannMF WoeltjeKF.Mycobacterium chelonae. Emedicine.2010.http:\/\/emedicine.medscape.com\/article\/222790\u2010overview. Accessed January 19 2012."},{"key":"e_1_2_7_3_2","unstructured":"KoiralaJ.Mycobacterium kansasii. Emedicine.2012.http:\/\/emedicine.medscape.com\/article\/223230\u2010overview. Accessed January 19 2012."},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/014556139907800509"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348940911801006"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.12.1050"},{"key":"e_1_2_7_7_2","first-page":"73","article-title":"Efficacy of long\u2010term administration of clarithromycin in the treatment of intractable chronic sinusitis","volume":"525","author":"Hashiba M","year":"1996","journal-title":"Acta Otolaryngol Suppl"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000027731"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.2003.1496"},{"key":"e_1_2_7_10_2","doi-asserted-by":"crossref","first-page":"S160","DOI":"10.1016\/S0194-5998(97)70089-5","article-title":"Mycobacterium avium complex infection of the paranasal sinuses","volume":"117","author":"Ferguson BJ","year":"1997","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00166-09"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.70.12.7571-7573.2004"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812437333","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599812437333","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812437333","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:23:38Z","timestamp":1760966618000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599812437333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,2]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2012,6]]}},"alternative-id":["10.1177\/0194599812437333"],"URL":"https:\/\/doi.org\/10.1177\/0194599812437333","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,2]]},"assertion":[{"value":"2011-10-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-01-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-02-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}