Candida auris, a novel Candida species was first described as an isolate from the ear canal of a patient in Japan in 2009. C. auris has important characteristics: difficult to identify with conventional bacterial tests, resistant to multi-antifungals, and easy to survive in the human body and in a normal environment. C. auris has been isolated in over 40 countries across six continents. Several outbreaks have been reported in hospitals. Infections caused by C. auris have become a global threat owing to its rapid spread worldwide and multidrug-resistant properties. A recent announcement from the Centers for Disease Control and Prevention recognizes C. auris as an urgent threat to the United States public health. This paper describes C. auris.

It has been suggested that staphylococcal enterotoxin (SE) may be involved in type 2 inflammation such as eosinophilic chronic rhinosinusitis via innate lymphoid cells. In this study, the clinical features of a total of 78 patients with sinusitis who visited our department between March 2018 and January 2021 and underwent serum SE-specific IgE testing, were investigated. The present study investigated the serum SE-specific IgE positive rate, and compared peripheral blood eosinophil count, total IgE, ImmunoCAP of various antigens, and JESREC score in the SE-specific IgE positive and the SE-specific IgE negative groups.

As a result, serum SE-specific IgE showed a positive rate of 14.1% (11/78 cases) overall, of which the SE-specific IgE positive rate of eosinophilic chronic rhinosinusitis was 26.8% (9/41 cases), which was significantly higher than the SE-specific IgE positive rate of non-eosinophilic chronic rhinosinusitis of 5.4% (2/37 cases). In the SE-specific IgE positive group, JESREC score was significantly higher, and the peripheral blood eosinophil count and total IgE also tended to be higher. Furthermore, the SE-specific IgE positive group tended to have higher complications of eosinophilic otitis media.

These results are consistent with the idea that serum SE-specific IgE reflects the pathophysiology of type 2 inflammation in eosinophilic chronic rhinosinusitis and is involved in its pathology.

Out of 1,710,644 people infected with novel coronavirus in Japan, 18,113 died till October 19, 2021. The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted the medical care system. Because the Department of Otolaryngology provides facilities for surgeries and treatments of the airway, the otolaryngologists are exposed to the risk of nosocomial infections. Nasal surgeries, such as endoscopic sinus surgery (ESS), are considered particularly dangerous due to the possibility of aerosol generation from the nasal cavity, which has high viral load. From April 2020 to May 2020, new appointments for nasal surgeries were suspended, and scheduled nasal surgeries, excluding emergency cases and cases related to malignant tumors, were postponed. After June 2020, polymerase chain reaction (PCR) tests for COVID-19 were possible. Therefore, nasal surgeries were resumed after performing PCR before surgery. After surgery resumptions, a temporary decrease in surgery cases was noted during the infection wave. A decrease of operations by approximately 70% was recorded in 2020 compared to the average for the past 3 years. Fortunately, no cases of COVID-19 were found during the perioperative period. Continuation of safe nasal surgeries is important for maintaining the quality of life of patients. It necessary to summarize and share the nasal surgery status in our department during the COVID-19 pandemic for safe operation in the future.

Allergic rhinitis (AR) causes sleep disturbances. However, studies reporting the impact of sublingual immunotherapy (SLIT) for AR-related sleep disturbances are limited. The purpose of this study was, for the first time, to evaluate in detail the impact of a 6-month SLIT treatment on the quality of sleep in house dust mite (HDM)-AR patients.

The total nasal symptom score (TNSS) and sleep disturbances in AR patients sensitive to HDM (n=23) were evaluated and compared using questionnaires accomplished by those who participated in the study. The questionnaire-based evaluation was repeated after 6 months of SLIT treatment to investigate the changes in TNSS and sleep disturbances due to the therapeutic intervention. We classified the subjects into two groups based on the baseline Pittsburgh sleep quality index (PSQI) score: one with no sleep disturbances before the start of treatment (normal-sleeping subjects, n=10, PSQI<6) and the other with sleep disturbances (poor-sleeping subjects, n=13, PSQI≥6).

PSQI was correlated positively with nasal obstruction score in the pretreatment phase (r=0.66, p<0.05). TNSS and PSQI scores improved significantly after 6 months of SLIT. After stratification, the nasal obstruction scores and PSQI scores did not vary significantly before and after treatment in the normal-sleeping subjects’ group, but the other group showed significant improvements after treatment.

SLIT may improve both nasal symptoms and the quality of sleep in HDM-AR patients suffering from sleep disturbances. Therefore, encouraging patients with AR to continue SLIT for as long as possible may help in improving their sleep quality.