A Prospective Study on Clinicopathological Profile of Fungal Rhinosinusitis
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 5
Abstract
Introduction: Kerala being agriculture based state with warm moist climate, favorable for fungal growth and fungal rhinosinusitis (FRS) is relatively common here. This study was conducted to evaluate the clinical and pathological profile of FRS with respect to symptomatology, age group, immunological status, category, risk factors, radiological presentation, treatment regimen, and recurrence. Materials and Methods: The study was conducted on 50 patients suspected of having FRS and treated as in patients in Government Medical College, Calicut, for 2 years. Clinical, radiological, microscopic, and microbiologic features were documented. Treatment modalities were also evaluated, and patients were followed up at 1 and 3 months. Results: Out of 50 patients 33 (66%) were diagnosed to have non-invasive FRS which include eosinophilic FRS (50%) and sinus fungal ball IN 16%. 12 (24%) patients were with invasive FRS, 5 (10%) with eosinophilic mucin rhinosinusitis among invasive FRS 8 (16%) acute fulminant type, 3 (6%) chronic, and 1 (2%) patient with granulomatous type. 11 out of 12 invasive FRS patients (91.67%) were diabetic. Computed tomography findings were suggestive of FRS in 54% of cases. Patients with invasive FRS underwent surgical debridement and systemic antifungal therapy. Those with non-invasive FRS underwent surgical clearance, and none had any type of recurrence. Aspergillus was found to be the most common pathogen in both groups. Mortality rate in invasive group was 16.67% and 3 had persistent blindness. Conclusion: FRS is common in warm humid areas. Allergic fungal rhinosinusitis is the most common subtype of FRS associated with allergy. Type 2 diabetes is a major risk factor in acute fulminant invasive fungal sinusitis. Intra orbital and intracranial extension denote poor prognosis. Blindness due to orbital involvement is not reversible even after aggressive treatment.
Authors and Affiliations
A Shahul Hameed, Shalini Kurian, P Muraleedharan Nampoothiri
Keywords
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