Although a causal relationship of S. aureus in patients with CRS has not been established, SEs might skew the cytokine response towards a Th2 phenotype inducing both eosinophilia and the production of polyclonal IgE (11), and thus contribute to, at least in some cases, the development of CRSwNP (8,12,13). Here, IGHE is linked to congenital rubella syndrome.