Study on incidence of fungal aetiology in cases of chronic rhinosinusitis: a teaching hospital based study

Kamalpreet Singh, Sunil Goyal, Arun Gupta


Background: To study the presence of fungus and their types in nasal swabs taken from osteomeatal complex and in cases of nasal polyp from the nearest point of osteomeatal complex under endoscopic vision from the patients of chronic rhinosinusitis, using fungal culture and smear as the diagnostic method and to ascertain radiological, endoscopic and clinicopathological correlation.

Methods: 100 patients with CRS attending ENT OPD at tertiary care hospital to know the presence of fungus and their types and correlate clinico-pathological findings among patients of CRS with positive fungal culture and staining with those without positive fungal culture and staining.  

Results: Positive fungal cultures and smear in all cases including those who underwent endoscopic sinus surgery tissue samples were submitted for fungal elements, eosinophilia and fungal culture. Evidence of fungal infection was obtained in 32% (n=32) cases. Amongst the total patients, in 68 (68%) patients fungal culture and smear were negative (Table 1). Correlation between CT score (Lund-Mackay) and endoscopic findings score (Lund- Mackay) among patients of CRS with positive fungal etiology and CRS without positive fungal etiology showed highly significant p value.

Conclusions: The fungal infection is frequent in patients with chronic rhinosinusitis (32%), though on the lower side when compared to various other studies which have shown much more incidence of fungus in cases of CRS using advanced diagnostic tools and better methods of sample collection. Based on our results, Aspergillus (71.875%) was the most frequent isolated fungus in CRS patients followed by Mucormycosis and Candida.


Fungus, Chronic rhino sinusitis, Etiology, Polyps and nasal discharge

Full Text:



Van CP, Van HH, Bachert C. Pathogenesis of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2006;6(6):487-94.

Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg 1997;117(3):1-7.

Van CP, Van HH, Bachert C. Pathogenesis of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2006;6(6):487-94.

Benninger MS. Adult chronic rhinosinusitis: Definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol- Head Neck Surg. 2003;129(3):1-32.

Catten MD, Murr AH, Goldstein JA, Anand N. Mhatre, PhD, Anil K. Lalwani, MD. Detection of Fungi in the Nasal Mucosa Using Polymerase Chain Reaction. Laryngoscope. 2001;111:399-403.

Lund VJ, Mackay IS. Staging in rhinosinusitis, Rhinology. 1993;31:183-4.

Ponikau JU, Sherris DA. The role of airborne mold in chronic rhinosinusitis. J Allergy Clin Immunol 2006;118(3):762-3.

Dall’Igna C, Palombini BC, Anselmi F, Araujo E, Dall’Igna DP. Fungal rhinosinusitis in patients with chronic sinusal disease. Rev Bras Otorrinolaringol (Engl Ed) 2005;71(6):712-20.

Gwaltney JM Jr, Phillips CD, Miller RD, Riker DK. Computed tomographic study of the common cold. N Engl J Med. 1994;330(1):25-30.

Gosepath J, Mann WJ. Current concepts in therapy of chronic rhinosinusitis and nasal polyposis. ORL J Otorhinolaryngol Relat Spec. 2005;67(3):125-36.

Rupa V, Thomas M. Different types of fungal sinusitis occurring concurrently: implications for therapy Eur Arch Otorhinolaryngol. 2013;270(2):603-8.

Data citation

Copyright form