Review Reports

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This article describes an interesting and detailed case of a patient with chronic granulomatous invasive fungal sinusitis of the maxilla, which was treated through surgery and oral antifungal therapy.

However, I have some minor comments to do:

1) Use of the word Aspergillus should be in italics, as they are Latin genus and species names.

2) It would be better if the bibliographic indices from the studies where you mention names appeared right after the author's name (for example, line 166 - the disease was noted by Alarifi et al. [15], where 5 out of 7....).

3) Minor grammatical edits, and certain sentences can be made clearer and more concise to enhance readability.

4) I think that the follow-up of three months is insufficient to demonstrate the success of the treatment applied.

Overall, the manuscript is well organized and informative for the clinical management of chronic granulomatous invasive fungal infection. 

Author Response

Comment 1 : Use of the word Aspergillus should be in italics, as they are Latin genus and species names.

Response : Thank you for the suggestion. We have now italicized Aspergillus throughout the manuscript and the same has been highlighted as red colored text in the revised manuscript.

Comment 2: It would be better if the bibliographic indices from the studies where you mention names appeared right after the author's name (for example, line 166 - the disease was noted by Alarifi et al. [15], where 5 out of 7....).

Response: The authors would like to thank for the valuable suggestion and the bibliographic indices has been changed to the format as suggested by the reviewers.

Comment 3: Minor grammatical edits, and certain sentences can be made clearer and more concise to enhance readability.

Response : We have carefully revised the manuscript to improve clarity and conciseness, making necessary grammatical edits for better readability. Thank you for your valuable feed back.

Comment 4: I think that the follow-up of three months is insufficient to demonstrate the success of the treatment applied.

Response: Thank you for your insightful feedback. We acknowledge that a longer follow-up period would provide a more comprehensive assessment of treatment success. However, due to non compliance from the patient's side, our study focused on the three-month follow-up. We believe this period still provides valuable preliminary insights, but we agree that future studies with extended follow-up would be beneficial. The same reason has been mentioned in the revised manuscript for your reference.

Reviewer 2 Report

Comments and Suggestions for Authors

In my opinion, authors should elaborate more on the issue of immunosuppression. the only thing that we know is that the patient is a young man from rural India. They do not report whether his social or family background may predispose him in any kind of immunosuppresion, for example feeding status or increased incidence of genes in his area that predispose in rare and mild immunosupression syndromes 

In addition, I have noticed only minor language/expression mistakes eg in line 213

Author Response

Comment 1 : In my opinion, authors should elaborate more on the issue of immunosuppression. the only thing that we know is that the patient is a young man from rural India. They do not report whether his social or family background may predispose him in any kind of immunosuppresion, for example feeding status or increased incidence of genes in his area that predispose in rare and mild immunosupression syndromes

Response: Thank you for your insightful feedback. While we did not have specific data on the patient’s social or genetic background, we recognize the importance of these factors in assessing immunosuppression. Also, as our institution is not equipped for a complete genetic and immunologic evaluation, we have mentioned these as limitations of our study in the revised manuscript.

Comment 2:In addition, I have noticed only minor language/expression mistakes eg in line 213

Response: the authors have rephrased the sentences for better clarity and the changes are shown in golden yellow font color in the revised manuscript. 

 

Reviewer 3 Report

Comments and Suggestions for Authors

Dear Authors,

I read with great interest your case report about aggresive fungal sinusitis.

However, there are some aspects that require your attention.

Figure 1, please remove any markings and text from the images, maybe insert dycom files if available.

In the Discussion section you need to expand on newer diagnostic tests such as MALDI-TOF that can visualize the fungus although the microbiology or the pathology results are scarce. Reference this to the work by Jeican II, Barbu Tudoran L, Florea A, Flonta M, Trombitas V, Apostol A, Dumitru M, Aluaș M, Junie LM, Albu S. Chronic Rhinosinusitis: MALDI-TOF Mass Spectrometry Microbiological Diagnosis and Electron Microscopy Analysis; Experience of the 2nd Otorhinolaryngology Clinic of Cluj-Napoca, Romania. J Clin Med. 2020 Dec 8;9(12):3973. doi: 10.3390/jcm9123973. PMID: 33302509; PMCID: PMC7763976.

Before the conclusions please insert a small paragraph about the limitations of the present study case such as the absence of various diagnostics tests in your healthcare facility.

Please update the references as you have titles from 1995 and1997. I am sure that there are newer works that are worth mentioning.

Looking forward to receiving the improve version of your manuscript.

Author Response

Comment 1: Figure 1, please remove any markings and text from the images, maybe insert dycom files if available.

Response : The authors thank for your valuable feed back and the images has been changed.

Comment 2: In the Discussion section you need to expand on newer diagnostic tests such as MALDI-TOF that can visualize the fungus although the microbiology or the pathology results are scarce. Reference this to the work by Jeican II, Barbu Tudoran L, Florea A, Flonta M, Trombitas V, Apostol A, Dumitru M, Aluaș M, Junie LM, Albu S. Chronic Rhinosinusitis: MALDI-TOF Mass Spectrometry Microbiological Diagnosis and Electron Microscopy Analysis; Experience of the 2nd Otorhinolaryngology Clinic of Cluj-Napoca, Romania. J Clin Med. 2020 Dec 8;9(12):3973. doi: 10.3390/jcm9123973. PMID: 33302509; PMCID: PMC7763976.

Response: Thank you for your valuable insight. The authors have included a short description about recent advances in diagnosing fungal pathogens under the heading discussion.

Comment 3: Before the conclusions please insert a small paragraph about the limitations of the present study case such as the absence of various diagnostics tests in your healthcare facility

Response: Thank you for your suggestions and the same has been included in the revised manuscript.

Comment 4: Please update the references as you have titles from 1995 and1997. I am sure that there are newer works that are worth mentioning.

Response : The authors were of the idea that it would be better if we acknowledge the original work on which the present day classifications has evolved. However, the authors have taken your suggestion into account, and the references have been updated accordingly. We sincerely appreciate your valuable time and thoughtful feedback in reviewing our manuscript.