Publication:

Demographic profile of fungal rhinosinusitis at a tertiary care centre

Background Fungal rhino sinusitis is rampant in the North Indian state of Punjab. The demographic profile, presentation and comorbidities have been analysed.

Methods 110 samples from the nasal cavity were collected in Oto-rhino-Laryngology services and processed in the Microbiology services of Dayanand Medical College and Hospital, Ludhiana. Nasal secretions and surgically excised tissue were processed and subjected to direct microscopy by potassium hydroxide (KOH) preparation as well as inoculated on Sabrouraud’s dextrose agar. Identification of fungal isolates was done as per standard procedures.

Results Fungal sinusitis was most common followed by acute invasive sinusitis, chronic invasive, granuloma (fungal ball) and granulomatous invasive fungal sinusitis. Males were affected more than females and the majority of the patients were from urban background. Allergic form of disease was commonly seen in younger age group as compared to the invasive form of the disease which was seen more in older patients. Nasal discharge was common presentation followed by nasal obstruction. Bronchial asthma and diabetes mellitus were co-morbidities. KOH positivity was 44.5% and fungal culture positivity was 33.6%. The common fungal isolate in this group was Aspergillus flavus (22.7%). The most common fungal isolate in the invasive group was Rhizopus spp. (4.5%) and Mucor spp. (3.6%).

Conclusions Elderly diabetic and asthmatic males are more susceptible to invasive fungal rhino sinusitis while the young males are vulnerable to the allergic fungal rhino sinusitis. Thereby control of diabetic status and appropriate allergy testing and desensitization is emphasised.