In recent years there has been a special attention to fungi as causative agent of rhinosinusitis. In order to study the role of fungi in development of sinusitis and nasal polyposis a study was done from August 2003 to January 2006 .Biopsy materials of maxillary, ethmoidal and frontal sinuses of 77 patients with clinical manifestation of sinusitis and resected polyps from 100 patients with nasal polyposis were examined by mycological and pathological methods. All specimens were studied by direct microscopy and culture. H&E, GMS and PAS stains were also applied to the sections in order to confirm the diagnosis. Invasive fungal sinusitis was diagnosed in 11 cases. Mycological culture of the samples yielded pure growth of fungi in above mentioned cases and most commonly isolated fungi was Aspergillus flavus (n = 5) followed by Aspergillus fumigatus (n = 3), Rhizopus spp. (n = 2) and Candida albicans (n = 1). Histopathological examination of the specimens also revealed tissue invasion by fungal elements in those cases. Predisposing factors in these patients were leukemia, diabetes mellitus and previous sinus and polyp surgery, respectively. Allergic fungal sinusitis also was seen in one patient and Alternaria sp. isolated from the allergic mucin. Fungal elements were shown in nine polyp samples by mycological methods and isolated fungi were A. flavus (n = 7), A. fumigates (n = 1) and Rhizopus spp. (n = 1). Tissue invasion by fungi also was observed by histopathological examination in 6 patients. All the patients with invasive sinusitis were expired. This study shows the need of early detection of fungal sinusitis in at risk population in order to start urgent treatment, fungi also could be considered as the causative factor in the development of nasal polyposis, This study also imply to A.flavus as common agent of fungal rhinosinusitis.
Full conference title:
Trends in Medical Mycology, 5th
- TIMM 5th (2013)