Prevalence and Clinicomycological Profile of Fungal Rhinosinusitis in a Tertiary Care Hospital

Abstract

Introduction: Fungi are being increasingly implicated in the aetiopathology of Chronic Rhinosinusitis (CRS). Fungal Rhinosinusitis (FRS) is frequently seen in diabetic or immunocompromised patients, although it has also been reported in immunocompetent individuals. The spectrum of fungal involvement runs from benign colonisation to potentially life-threatening invasive disease. There are only a few landmark studies from India on FRS. Aim: To determine the prevalence of FRS and to analyse its clinicomycological profile. Materials and Methods: Thirty-nine patients with clinical suspicion of CRS during a period of one year were included in this prospective study. The sinonasal specimens were subjected to microscopy by potassium hydroxide (KOH) mount followed by fungal culture as per standard mycological technique. Specimens were also subjected to Histopathological Examination (HPE). The obtained data from the study was analysed by chi-square test using Statistical Package for the Social Sciences (SPSS) software. Results: The prevalence of FRS in this study was 41% (n=16) with a higher prevalence among third and fourth decades (n=10, 62.5%) of life, with a female predominance (n=11, 68.75%). Aspergillus spp. was the most prevalent organism (n=6) with A. flavus (4/6) being the commonest species. Allergic FRS (43.75%) was the most common presentation. The prevalence was higher among individuals who were immunocompetent (11/16). Conclusion: As FRS varies in presentation, perfect mycological identification plays a crucial role in diagnosing chronic sinusitis and also provides therapeutic guidance for the treatment of infection with unusual agents.

Keywords

• allergic fungal rhinosinusitis
• aspergillus flavus
• chronic rhinosinusitis
• invasive fungal infections