A Clinicomorphological study of Fungal Rhinosinusitis

The prevalence of rhinosinusitis is estimated to be 14 percentage of the global population. Chronic rhinosinusitis (CRS) is a multifactorial problem caused by interaction of numerous host and non-host factors leading to the disease .The host factors are anatomic variations like septal deviation, nasal polyposis, cystic fibrosis (CF), Youngs syndrome, primary ciliary dyskinesia and immunocompromised state. The environmental and other non-host factors are cigarette smoking, atopy, fungal infection and bacterial infection. The most common cause of bacterial rhinosinusitis is coagulase-negative staphylococci, Hemophilus influenzae, Staphylococcus aureus, and Streptococcus pneumoniae. Fungi as a causative agent of sinusitis are on the rise and allergic fungal rhinosinusitis (AFR) accounts for 5 -10 percentage of all CRS cases.The organisms usually implicated are Aspergillus species and organisms in the Mucorales order (Rhizopus, Rhizomucor, Absidia, Mucor, Cunninghamella, Mortierella, Saksenaea and Apophysomyces). There exists a demographic variation in the fungi causing rhinosinusitis with the dematiaceous fungi being the most common cause of rhinosinusitis in the west, while aspergillus is implicated as the most common cause of rhinosinusitis in India. Hence we report the histomorphology of fungal sinusitis diagnosed in our hospital from January 2012 to August 2013 and present the results with a discussion.