Clinical study of fungal sinusitis

Abstract

Background: Fungal sinusitis is a distinct clinical entity characterized by inflammation of the sinus mucosa caused by fungal infection like aspergillus (fumigatus, niger, flavus), mucormycosis, candida (albicans), scedosporium, pencillium. Mostly immunocompromised patients, farmers, garbage cleaners, and patients on prolonged nasal sprays are affected. There are different types of fungal sinusitis: fungal mycetoma, allergic fungal, chronic indolent and fulminant sinusitis having symptoms like chronic headache and facial swelling with visual impairment. Patients have thick purulent nasal discharge, nasal obstruction, epistaxis, cheek swelling and may be polyposis. Resident bacterial flora probably inhibits colonization by fungi through a number of mechanisms. Thus antimicrobial therapy predisposes to both the overgrowth of normal fungal flora, e.g., Candida species, and growth of opportunists like Aspergillus¹. Allergic fungal rhinosinusitis is the most common entity. Aspergillosis is the most common fungal infection. Of these aspergillus fumigatus is the most common fungal pathogen. Maxillary sinuses are commonly involved.

Methods: This is a prospective study carried out at department of otorhinolaryngology at Kunal Institute of Medical Specialities Pvt Ltd. Evaluation by proper history taking and clinical examination after which the patient is selected for nasal swab, culture and sensitivity. Plain x-ray nose and paranasal sinuses. CT scans nose and paranasal sinuses. Diagnostic nasal endoscopy.  

Results: Allergic fungal sinusitis was the most common entity found with aspergillosis being the most common organism.

Conclusions: Allergic fungal sinusitis was most commonly found in the age group of 20 to 29 years with maxillary sinus most commonly affected.