Prevalence of fungal rhinosinusitis among immunocompetent patients with chronic rhinosinusitis from Iran-sari

M. Bahoosh1, M.T. Hedayati1, A. Kasiri2, M. Ghasemi3, S.J. Motahhari3, R. Poormusa3

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Background: Fungal rhinosinusitis (FRS) is one of the most important and confusing disease in patients with chronic rhinosinusitis (CRS). The true incidence and aetiopatogenesis of FRS among patients with CRS remain unclear. In the present study we evaluated the occurrence of FRS and those causative agents in immunocompetent patients with refractory CRS from Sari city, Iran. Materials and Methods: During one year, we studied FRS in 50 consecutive patients with CRS undergoing Functional endoscopic sinus surgery at Boo Ali hospital from Sari. Surgical sinus specimens were analyzed by histopathological and modified mycological methods. These samples were also processed for fungal culture. Total serum IgE was evaluated in all patients. Results: Nasal obstruction and congestion was the commones (96.0%) clinical presentation. Out of 50 patients, 70.0% and 40.0% patients were positive for fungi by microscopic and culture methods, respectively. Aspergillus (45.0%) was the commonest isolated fungi. 12(24.0%) patients showed allergic fungal rhinosinusitis (AFRS). Nasal polyps, history of atopy and eosinophilic mucin were seen in all patients with AFRS. 3(6.0%) patients met criteria for sinus fungal ball. Aspergillus was the most prevalent isolated fungi from all categories of FRS. Conclusion: In concordant to other studies from warm and humid regions, we also showed that FRS is a common disorder in patients with CRS and Aspergillus as the prevalent isolated fungi in these patients. Sinonasal polyps, history of atopy and eosinophilic mucin showed strong association with AFRS therefore using of these items as important criteria in diagnosis of AFRS are emphasized. We demonstrated using a standard mycology laboratory protocol; fungus can be isolated from majority of CRS patients. In this study we reported Exophiala oligosperma for first time from Iran. Keywords: Chronic rhinosinusitis, fungal rhinosinusitis; allergic fungal rhinosinusitis; Aspergillus

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Full conference title: 

Iranian Congress on Medical Mycology
    • ICMM 2011