Incidence of fungal etiology in patients with nasal polyps

Introduction: Nasal polyposis is an inflammatory condition of varied etiology, of which fungal etiology is an important cause. Allergic fungal sinusitis (AFS) now is believed to be an allergic reaction to aerosolized environmental fungi in an immunocompetent host. Aim and objectives: To determine the incidence of fungal etiology in the patients presenting with nasal polyps and correlate the histopathological findings with microbiological fungal cultures. Materials and methods: This study has been carried out over a period of 2 years from July 2014 to June 2016 in the Department of Pathology, Gandhi Hospital. Histopathological sections of resected nasal polyps from 52 patients were studied for the presence of fungi and results correlated with fungal cultures done in Department of Microbiology. Results: Majority of the polyps were unilateral 92% (48), seen in males 54% (28), most common in 3rd decade 27% (14). Histologically, 80% (40) of cases showed eosinophils and 23% of cases (12) showed presence of fungal hyphae. Fungal culture was positive in 34.6% (18 cases) with Aspergillus being the most common comprising 21% (11 cases). Others were candida pseudotropicalis 1.9% (1 case), Rhizopus 5.7% (3 cases), Mucor 3.8% (2 cases), and penicillium 1.9% (1 case). Conclusion: The incidence of fungal etiology in nasal polyps is significantly higher in our study compared to the west. Hence it is crucial to look for the presence of fungus in nasal polyps before administering treatment as use of antifungal therapy will benefit patients and prevent recurrence.