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Updated: Feb 23, 2026

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Fungal Rhinosinusitis: Microbiological and Histopathological Perspective.

Ajay Kumar Singh1, Prashant Gupta2, Nitya Verma3

  • 1Associate Professor, Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Journal of Clinical and Diagnostic Research : JCDR
|September 13, 2017
PubMed
Summary

This study compared diagnostic methods for fungal rhinosinusitis (FRS), finding that combining histopathology with microbiological techniques improves diagnosis accuracy for FRS.

Keywords:
AllergyCultureFungal ballHistopathology

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Area of Science:

  • Otolaryngology
  • Mycology
  • Diagnostic Pathology

Background:

  • Fungal rhinosinusitis (FRS) classification relies on histopathology, differentiating between non-invasive and invasive types for treatment guidance.
  • Evaluating the efficacy of molecular (PCR) and conventional (KOH microscopy, culture) diagnostic methods alongside histopathology is crucial.

Purpose of the Study:

  • To histopathologically and microbiologically analyze fungal rhinosinusitis cases.
  • To compare the diagnostic yield of KOH microscopy, culture, PCR, and histopathology in suspected FRS cases.

Main Methods:

  • Seventy-six clinically suspected FRS cases were analyzed.
  • Tissue samples underwent KOH microscopy, fungal culture, PCR, and histopathological examination using PAS, GMS, and H&E stains.

Main Results:

  • FRS was diagnosed in 48.68% of cases (37/76).
  • PCR showed the highest detection rate (35.5%), followed by culture (27.6%), direct microscopy (22.3%), and histopathology (18.42%).
  • Allergic Fungal Rhinosinusitis (AFRS) was the most common type (64.2% of histopathologically confirmed cases), with Aspergillus flavus identified as the predominant fungus.

Conclusions:

  • A single diagnostic method is insufficient for FRS diagnosis.
  • Integrated histopathological and microbiological approaches are recommended, particularly for challenging cases.