The management of sinusitis is often aided by bacterial and fungal cultures from which Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and occasionally aerobic Gram-negative bacilli are the most commonly recovered pathogenic organisms. The Corewell Health West Microbiology Lab has several orders available for culturing sinus specimens collected as fluid aspirates, tissue, or swabs. Though more challenging to collect, aspirates are preferred over swab cultures that often grow mixed normal upper respiratory flora for which it is difficult to interpret the clinical significance.
| Available Sinus Culture Orders | Default Specimen Type | Comments |
| Body Fluid Culture [LAB2111016]
Respiratory Culture [LAB3095] Tissue Culture [LAB2111173] |
Aspirated fluid
Swabbed collection Tissue |
For aerobic bacteria |
| Fungal Culture [LAB240] | Aspirated fluid or tissue, preferred
Swabbed collection |
For fungal organisms |
| Anaerobic Culture [LAB233] | Aspirated fluid or tissue* | For anaerobic bacteria |
* Aspirate and tissue specimens are acceptable for anaerobic culture, however, sinus swabs are not due to their regular contamination with anaerobes that colonize the upper airways. Any pathogenic contribution from anaerobes, more typical in chronic sinusitis, is often due to a mixed population of anaerobic organisms for which amoxicillin-clavulanate or metronidazole may be considered for empiric therapy. Middle meatal swabs obtained with endoscopic guidance may be considered for aerobic Respiratory Culture and Fungal Culture due to their relative concordance with culture of maxillary sinus aspirates obtained by antral puncture.
References
- Miller JM, Binnicker MJ, Campbell S, Carroll KC, Chapin KC, Gilligan PH, Gonzalez MD, Jerris RC, Kehl SC, Patel R, Pritt BS, Richter SS, Robinson-Dunn B, Schwartzman JD, Snyder JW, Telford S 3rd, Theel ES, Thomson RB Jr, Weinstein MP, Yao JD. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018 Aug 31;67(6):e1-e94.
- Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-S39.
