DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20190758

Prevalence and clinical profile of patients with chronic fungal maxillary sinusitis

Vijay Gupta, Arindam Gupta

Abstract


Background: Fungal paranasal sinus disease is considered to be rare but there has been a marked increase in the number and diversity of reported cases of fungal infections of maxillary sinus in recent years. Objectives were to study the incidence of fungal infection in case of chronic maxillary sinusitis, to identify specific type of fungus involved in maxillary sinus infection and to study clinical profile of the patients with fungal infections of maxillary sinus.

Methods: A prospective study of was conducted involving the patients attending outpatient department of Otorhinolaryngology, who were clinically and radiologically proved cases of chronic maxillary sinusitis. Patients diagnosed with underlying paranasal sinus malignancies were excluded from the study. 70 patients of chronic maxillary sinusitis were included in the study. Isolates were identified based on colonial and microscopical morphology. Subcultures were done and slide cultures were prepared to identify the fungi.  

Results: Fungus was cultured from 12.8% of patients suffering from chronic maxillary sinusitis. The most frequent victims of the disease were young persons in the second decade of life. All patients found positive for fungus had unilateral maxillary sinusitis. Aspergillus niger, Aspergillus fumigatus, Candida albicans and Mucormycosis were the various fungi isolated from cultures of antral washings.

Conclusions: The results of the study emphasise the role of fungi as important pathogens of chronic maxillary sinusitis. There must be high index of suspicion of fungal infection when a young adult with a unilateral antral opacity on X-ray with frank pus in antral washings.

 


Keywords


Aspergillus, Fungal rhinosinusitis, Chronic maxillary sinusitis, Prevalence

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References


Sharma D, Mahajan N, Rao S, Khurana N, Jain S. Invasive maxillary aspergillosis masquerading as malignancy in two cases: utility of cytology as a rapid diagnostic tool. J Cytol. 2012;29:194–6.

Fanucci E, Nezzo M, Neroni L, Montesani L, Ottria L, Gargari M. Diagnosis and treatment of paranasal sinus fungus ball of odontogenic origin: case report. Oral Implantol (Rome). 2014;6(3):63-6.

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.

Soler ZM, Schlosser RJ. The role of fungi in diseases of the nose and sinuses. Am J Rhinol Allergy. 2012;26(5):351-8.

Ramadan HH, Meyers AD. Fungal Sinusitis. Medscape. Available at https://emedicine.medscape.com/article/863062-print, 2018. Accessed 25 November 2018.

Schubert MS. Allergic fungal sinusitis: pathophysiology, diagnosis and management. Medical Mycology. 2009;47(S1):S324–30.

Chakrabarti A, Rudramurthy SM, Panda N, Das A, Singh A. Epidemiology of chronic fungal rhinosinusitis in rural India. Mycoses. 2015;58(5):294-302.

Das A, Bal A, Chakrabarti A, Panda N, Joshi K. Spectrum of fungal rhinosinusitis; histopathologist’s perspective. Histopathology. 2009;54:854–9.

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;31:266–9.

Dall-Igna C, Palombini BC, Anselmi F, Araújo E, Dall-Igna DP. Fungal rhinosinusitis in patients with chronic sinusal disease. Rev Bras Otorrinolaringol. 2005;71(6).

Marple BF, Mabry RL. Comprehensive management of allergic fungal sinusitis. Am J Rhinol. 1998;12(4):263-8.

Shah H, Bhalodiya N. Scenario of Fungal Infection of Nasal Cavity and Paranasal Sinuses in Gujarat: A Retrospective Study. Gujarat Med J. 2014;69(2):27-31.

Joshi RR, Bhandary S, Khanal B, Singh RK. Fungal maxillary sinusitis: a prospective study in tertiary care hospital of eastern Nepal. Kathmandu Univ Med J. 2007;5(2):195–8.

Karthikeyan P, Nirmal Coumare V. Incidence and presentation of fungal sinusitis in patient diagnosed with chronic rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2011;62(4):381-5.

Krishnan K U, Agatha D, Selvi R. Fungal rhinosinusitis: A clinicomycological perspective. Indian J Med Microbiol. 2015;33:120-4.

McClay JE, Marple B, Kapadia L, Biavati MJ, Nussenbaum B, Newcomer M, et al. Clinical presentation of allergic fungal sinusitis in children. Laryngoscope. 2002;112(3):565-9.

Stammberger H, Kennedy DW. Paranasal sinuses: Anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl. 1995;167:7–16.

Killeen DE, Sedaghat AR, Cunnane ME, Gray ST. Objective radiographic density measurements of sinus opacities are not strong indicators of noninvasive fungal diseases. Am J Rhinol Allergy. 2014;28:483–6.

Waghray J. Clinical study of fungal sinusitis. Int J Otorhinolaryngol Head Neck Surg. 2018;4(5):1307-12.

Rupa V, Jacob M, Mathews MS, Job A, Kurien M, Chandi SM. Clinicopathological and mycological spectrum of allergic fungal sinusitis in South India. Mycoses. 2002;45:364-7.

Chakrabarti A, Sharma SC, Chander J. Epidemiology of pathogenesis of paranasal sinus mycosis. Otolaryngol Head Neck Surg. 1992;107:745-50.