FUNGAL INFECTION PREVALENCE IN CHRONIC RHINOSINUSITIS POST-SURGERY
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Keywords
Chronic Rhinosinusitis, Fungal Rhinosinusitis, Aspergillus, Functional Endoscopic Sinus Surgery (FESS), KOH Microscopy.
Abstract
Background: Chronic rhinosinusitis (CRS) can be associated with fungal infections, particularly Aspergillus species. This study aimed to evaluate the clinical, radiological, and mycological features of fungal rhinosinusitis in patients undergoing treatment at a tertiary medical center.
Methods: This prospective observational study included 50 patients with CRS treated at GIMSH, Durgapur between June and July 2024. Nasal sinus tissue and secretion samples were collected during functional endoscopic sinus surgery (FESS) for mycological and bacteriological analysis. Fungal elements were identified using KOH mounts and cultured on Sabouraud dextrose agar. Bacterial cultures were grown on MacConkey agar and identified using biochemical tests.
Results: Fungal cultures were positive in 28% (14/50) of patients, with Aspergillus being the most frequently isolated genus. All sinuses were involved in 80% (40/50) of patients, and 48% (24/50) had nasal polyps, predominantly bilateral. A strong correlation was observed between KOH positivity and culture positivity, with 90% (9/10) of KOH-positive samples also culture-positive, and 97% (35/36) of KOH-negative samples also culture-negative.
Conclusions: Fungal infections, particularly Aspergillus, are significant contributors to CRS. KOH microscopy serves as a reliable preliminary diagnostic tool for fungal rhinosinusitis. FESS followed by appropriate antifungal therapy is essential for effective management.
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Dr. Indranil Mukherjee
Associate Professor, Department of ENT, Gouri Devi Institute Of Medical Sciences & Hospital, Durgapur