Evaluation of clinicomycological profile in patients of chronic rhinosinusitis

Dimple Sahni; Sandeep  Kaur; Sangeeta Aggarwal; Amandeep Kaur; Priya Sahni

doi:10.18203/2394-6040.ijcmph20261774

Authors

Dimple Sahni Department of ENT, Government Medical College (GMC), Patiala, Punjab, India
Sandeep Kaur Department of ENT, Government Medical College (GMC), Patiala, Punjab, India
Sangeeta Aggarwal 2Department of ENT, Gian Sagar Medical College, Rajpura, Punjab, India
Amandeep Kaur Department of ENT, Government Medical College (GMC), Patiala, Punjab, India
Priya Sahni Department of Social and Preventive Medicine, All India Institute of Medical Sciences (AIIMS), Bathinda, Punjab, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261774

Keywords:

Aspergillus, Chronic rhinosinusitis, Fungal sinusitis, Nasal polyposis

Abstract

Background: Rhinosinusitis (RS) poses a major health problem, substantially affecting quality of life, productivity, and finances.

Methods: This prospective clinical study was conducted in the Department of ENT at Government Medical College, Patiala, from March 2022 to June 2024 (2 years) involving 60 patients diagnosed with Chronic Rhinosinusitis (CRS) based on the diagnostic criteria outlined in the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS-2012).

Results: The study comprised patients with a mean age of 37.42 years (±14.43) with male to female ratio of 1.22:1. Mycological evaluation showed fungal filaments on KOH mount in 35% patients and Aspergillus flavus being the most frequently isolated species on culture. Histopathological analysis confirmed fungal rhinosinusitis in 30% of patients, with allergic fungal rhinosinusitis being the most common finding, followed by fungal ball.

Conclusions: In our study, Aspergillus flavus being the most commonly isolated fungus, followed by Aspergillus fumigatus and Mucorales species. These findings highlight the common fungal association in CRS. Mycological identification is essential for accurate diagnosis, guiding appropriate treatment and preventing complications.

Metrics

Metrics Loading ...

References

Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinol. 2012;50(1):1-2. DOI: https://doi.org/10.4193/Rhino12.000

Akdis CA, Bachert C, Cingi C, Dykewicz MS, Hellings PW, Naclerio RM, et al. Endotypes and phenotypes of chronic rhinosinusitis: a PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. J Aller Clin Immun. 2013;131(6):1479-90. DOI: https://doi.org/10.1016/j.jaci.2013.02.036

Tomassen P, Zele TV, Zhang N, Perez-Novo C, Bruaene NV, Gevaert P, et al. Pathophysiology of chronic rhinosinusitis. Proc Am Thorac Soc. 2011;8(1):115-120. DOI: https://doi.org/10.1513/pats.201005-036RN

Davis LJ, Kita H. Pathogenesis of chronic rhinosinusitis: role of airborne fungi and bacteria. Immunol Allergy Clin North Am. 2004;24(1):59-73. DOI: https://doi.org/10.1016/S0889-8561(03)00103-6

Caughey RJ, Jameson MJ, Gross CW, Han JK. Anatomic risk factors for sinus disease: fact or fiction? Am J Rhinol. 2005;19(4):334-9. DOI: https://doi.org/10.1177/194589240501900402

Hissaria P, Smith W, Wormald PJ, Taylor J, Vadas M, Gillis D, et al. Short course of systemic corticosteroids in sinonasal polyposis: a double-blind, randomized, placebo controlled trial with evaluation of outcome measures. J Aller Clin Immunol. 2006;118(1):128-33. DOI: https://doi.org/10.1016/j.jaci.2006.03.012

Chakrabarti A, Sharma SC. Paranasal sinus mycoses. Indian J Chest Dis Allied Sci. 2000;42(4):293-304.

Ferguson BJ. Definitions of fungal rhinosinusitis. Otolaryngol Clin North Am. 2000;33(2):227-35. DOI: https://doi.org/10.1016/S0030-6665(00)80002-X

Shazo RD, O’Brien M, Chapin K, Soto-Aguilar M, Swain R, Lyons M, et al. Criteria for the diagnosis of sinus mycetoma. J Allergy Clin Immunol 1997;99(4):475-85. DOI: https://doi.org/10.1016/S0091-6749(97)70073-3

Manning SC, Schaefer SD, Close LG, Vuitch F. Culture-positive allergic fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1991;117(2):174-8. DOI: https://doi.org/10.1001/archotol.1991.01870140062007

Morpeth JF, Rupp NT, Dolen WK, Bent JP, Kuhn FA. Fungal sinusitis: an update. Ann Allergy Asthma Immunol. 1996;76(2):128-39. DOI: https://doi.org/10.1016/S1081-1206(10)63411-4

Stammberger H, Jakse R, Beaufort F. Aspergillosis of the paranasal sinuses: X-ray diagnosis, histopathology, and clinical aspects. Ann Otol Rhinol Laryngol. 1984;93(3):251-6. DOI: https://doi.org/10.1177/000348948409300313

Pillsbury HC, Fischer ND. Rhinocerebral mucormycosis. Arch Otolaryngol. 1977;103(10):600-4. DOI: https://doi.org/10.1001/archotol.1977.00780270068011

Denning DW. Treatment of invasive aspergillosis. J Infect. 1994;28:25-33. DOI: https://doi.org/10.1016/S0163-4453(94)95941-2

McGill TJ, Simpson G, Healy GB. Fulminant aspergillosis of the nose and paranasal sinuses: A new clinical entity. Laryngoscope.1980;90(5):748-54. DOI: https://doi.org/10.1288/00005537-198005000-00003

Jahromii SB, Khaksar AA. Paranasal sinus mycosis in suspected fungal sinusitis. Iran J Clin Infect Dis. 2006;1(1):25-9.

Krishnan KU, Agatha D, Selvi R. Fungal rhinosinusitis: a clinicomycological perspective. Indian J Med Microbiol. 2015;33(1):120-4. DOI: https://doi.org/10.4103/0255-0857.148407

Tanveer U, Gul A, Aqil S. Incidence and recurrence of allergic fungal sinusitis at tertiary care facility. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 3):1832-6. DOI: https://doi.org/10.1007/s12070-017-1218-y

Milosev B, el-Mahgoub S, Aal OA, el-Hassan AM. Primary aspergilloma of paranasal sinuses in the Sudan. A review of seventeen cases. Br J Surg. 1969;56(2):132-7. DOI: https://doi.org/10.1002/bjs.1800560213

Panda NK, Sharma SC, Chakrabarti A, Mann SB. Paranasal sinus mycoses in north India. Mycoses. 1998;41(7-8):281-6. DOI: https://doi.org/10.1111/j.1439-0507.1998.tb00339.x

Choudhary S, Solanki B, Chouhan M, Gupta D. A clinico-pathological study of allergic fungal rhinosinusitis at a tertiary care center of western Rajasthan. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):4640-5. DOI: https://doi.org/10.1007/s12070-021-02937-7

Munjal M, Gupta V, Chinna D, Virdi S, Munjal S, Gupta V. Demographic profile of fungal rhinosinusitis at a tertiary care centre. Int J Otorhinolaryngol Head Neck Surg. 2021;7(1):61-5. DOI: https://doi.org/10.18203/issn.2454-5929.ijohns20205621

Ravindra P, Viswanatha B. A clinicopathological and microbiological study of fungal rhinosinusitis. J Otolaryngol ENT Res. 2019;11(1):49-52. DOI: https://doi.org/10.15406/joentr.2019.11.00408

Kaur R, Lavanya S, Khurana N, Gulati A, Dhakad MS. Allergic fungal rhinosinusitis: a study in a tertiary care hospital in India. J Allergy (Cairo). 2016;2016(1):7698173. DOI: https://doi.org/10.1155/2016/7698173

Prateek S, Banerjee G, Gupta P, Singh M, Goel MM, Verma V. Fungal rhinosinusitis: A prospective study in a University hospital of Uttar Pradesh. Indian J Med Microbiol. 2013;31(1):266-9. DOI: https://doi.org/10.4103/0255-0857.115634

Singh AK, Gupta P, Verma N, Khare V, Ahamad A, Verma V, et al. Fungal rhinosinusitis: microbiological and histopathological perspective. J Clin Diagn Res. 2017;11(7):DC10-12. DOI: https://doi.org/10.7860/JCDR/2017/25842.10167

Suresh S, Arumugam D, Zacharias G, Palaninathan S, Vishwanathan R, Venkatraman V. Prevalence and clinical profile of fungal rhinosinusitis. Allergy Rhinol (Providence). 2016;7(2):115-20. DOI: https://doi.org/10.2500/ar.2016.7.0156