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Fungal rhino sinusitisin in tehran, iran
Mehdi Nazeri1, Seyed Jamal Hashemi1, Mohammad Ardehali2
1Dept. of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Fungal rhino sinusitis (FRS) is an important infection of para nasal sinuses, which encompasses two main categories; invasive and noninvasive forms according to histopathological findings. Aspergillus spp are the most common species isolated from noninvasive form, while Mucorales are more frequently isolates from acute infections.
Methods:
Four hundred fifty patients suspected to fungal rhino sinusitis were investigated in a cross-sectional prospective study from June 2009 to Sep 2013. All patients under went endoscopic sinus surgery of the middle meatus. Tissue biopsies were investigated for culture, histopathology and molecular examination.
Results:
Totally, 87 patients were diagnosed with fungal rhinosinusitis. A. flavus was the most common etiological agent of chronic invasive form (CIFRS), allergic fungal rhino sinusitis (AFRS) and fungus ball (FB), while Rhizopus oryze (26.7%) was the most common cause of infection in acute invasive fungal rhino sinusitis (AIFR). However, a few rare species such as Shyzophyllum commune and Fusarium proliferatum were also isolated.
Conclusion:
Diabetes is the most important predisposing factor for patients with acute invasive form of sinusitis and the most involved sinuses were unilateral multiple sinuses and maxillary sinus.
Insights
Fungal rhinosinusitis (FRS) diagnosis identified Aspergillus flavus as the primary cause in chronic and allergic forms. Rhizopus oryze was most common in acute invasive FRS, with diabetes a key predisposing factor.
Area of Science:
- Otolaryngology
- Mycology
- Infectious Diseases
Background:
- Fungal rhinosinusitis (FRS) presents as invasive or noninvasive forms.
- Aspergillus species are common in noninvasive FRS, while Mucorales are frequent in acute infections.
Purpose of the Study:
- To investigate the etiological agents and predisposing factors of fungal rhinosinusitis.
Main Methods:
- A cross-sectional prospective study of 450 patients suspected of FRS from June 2009 to September 2013.
- Patients underwent endoscopic sinus surgery, with tissue biopsies analyzed via culture, histopathology, and molecular methods.
Main Results:
- Eighty-seven patients were diagnosed with FRS.
- Aspergillus flavus was the most common agent in chronic invasive FRS, allergic FRS, and fungus balls.
- Rhizopus oryze (26.7%) was the leading cause of acute invasive FRS; rare species like Shyzophyllum commune and Fusarium proliferatum were also found.
Conclusions:
- Diabetes mellitus is a significant predisposing factor for acute invasive FRS.
- Unilateral multiple sinuses and the maxillary sinus were most frequently involved in acute invasive FRS.
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