Fungal Rhinosinusitis: Microbiological and Histopathological Perspective

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.