Publication:

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

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.