A Clinicomorphological study of Fungal Rhinosinusitis

Abstract

The prevalence of rhinosinusitis is estimated
to be 14 percentage of the global
population. Chronic rhinosinusitis (CRS) is
a multifactorial problem caused by interaction
of numerous host and non-host factors
leading to the disease .The host factors
are anatomic variations like septal deviation,
nasal polyposis, cystic fibrosis (CF),
Youngs syndrome, primary ciliary dyskinesia
and immunocompromised state. The
environmental and other non-host factors
are cigarette smoking, atopy, fungal infection
and bacterial infection. The most common
cause of bacterial rhinosinusitis is coagulase-
negative staphylococci, Hemophilus
influenzae, Staphylococcus aureus,
and Streptococcus pneumoniae. Fungi as
a causative agent of sinusitis are on the
rise and allergic fungal rhinosinusitis (AFR)
accounts for 5 -10 percentage of all CRS
cases.The organisms usually implicated
are Aspergillus species and organisms in
the Mucorales order (Rhizopus, Rhizomucor,
Absidia, Mucor, Cunninghamella, Mortierella,
Saksenaea and Apophysomyces).
There exists a demographic variation in
the fungi causing rhinosinusitis with the
dematiaceous fungi being the most common
cause of rhinosinusitis in the west,
while aspergillus is implicated as the most
common cause of rhinosinusitis in India.
Hence we report the histomorphology of
fungal sinusitis diagnosed in our hospital
from January 2012 to August 2013 and
present the results with a discussion.