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Related Experiment Video

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Fungal Rhinosinusitis: An integrated diagnostic approach.

R Soundarya1, H C Deepa1, Peralam Yegneswaran Prakash2

  • 1Department of Pathology, Kasturba medical college, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India.

Annals of Diagnostic Pathology
|November 30, 2024
PubMed
Summary

Histopathology aids early fungal rhinosinusitis (FRS) diagnosis. This study classified FRS cases, finding invasive forms more common and demonstrating histopathology

Keywords:
Allergic fungal sinusitisAspergillusCOVID-19Invasive fungal infectionsMucoralesRhinosinusitis

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Area of Science:

  • Otolaryngology
  • Mycology
  • Pathology

Background:

  • Accurate classification of fungal rhinosinusitis (FRS) is crucial for effective patient management.
  • Histomorphology and clinical presentation are key diagnostic factors in FRS.

Purpose of the Study:

  • To evaluate clinicopathologic findings in patients diagnosed with FRS.
  • To classify FRS cases into non-invasive and invasive subtypes.
  • To compare histopathology with fungal cultures for diagnostic accuracy.

Main Methods:

  • Retrospective observational study of 85 FRS patients (Jan 2019-Dec 2021).
  • Review of clinical, imaging, and histopathological findings.
  • Classification into non-invasive (fungal ball, allergic FRS) and invasive (acute, chronic, granulomatous) FRS.
  • Comparison of histopathology with fungal culture results for Aspergillus.

Main Results:

  • 66% of cases were invasive FRS, with acute invasive fungal rhinosinusitis (AIFRS) being most common (70%).
  • Non-invasive FRS constituted 34% of cases, predominantly fungal ball (FB).
  • Histopathology showed 90% sensitivity and 96% specificity for Aspergillus compared to mycology.
  • Diabetes and COVID-19 co-infection were common comorbidities.

Conclusions:

  • An integrated diagnostic approach is valuable for accurate FRS diagnosis.
  • Histopathological evaluation serves as an effective screening tool, especially in resource-limited settings.
  • Early diagnosis through histopathology facilitates prompt patient management.