Acute Invasive Fungal Rhino-sinusitis: Clinical, Microbiological and Pathological Diagnosis
Shawky Elmorsy
Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt.
Shirien Amin Rakha
Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt.
Noha Tharwat Abou El- Khier *
Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt.
Safaa Mohamad EL-Ageery
Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt.
Nawal S. Gouda
Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Egypt.
Hoda Saleh
Department of Pathology, Faculty of Medicine, Mansoura University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Acute invasive fungal rhinosinusitis (AIFRS) is a challenging disorder that is diagnosed frequently in immunocompromised patients with very rapid progression.
Objective: to estimate the burden of AIFRS in Mansoura University Hospitals and to assess the mycological and clinicopathological profile of the disease.
Methods: Specimens were subjected to microbiological and histopathological examinations. Data about demographic characters, underlying diseases, presenting symptoms, signs, surgical interventions, and complications were collected.
Results: Twenty-two patients were diagnosed as AIFRS. Patients were 15 males and 7 females with age ranged from 14 to 55 years. The disease was prevalent among immunocompromised patients (100%). Hematological malignancies were the most common underlying conditions (68.18%), The remaining patients had disorders associated with immunosuppression as solid organ transplantation (18.18%) and non-insulin-dependent diabetes mellitus (13.64%). Culture results were positive only in 15 patients (68.18%). Aspergillus species (8/15) were the most common isolated organisms followed by Zygomycetes (7/15).
Conclusions: AIFRS continues to present a challenge to the otolaryngologist who must be highly suspicious at risk patient populations. Histopathological examination had high sensitivity. The isolated organisms were Aspergillus species and Rhizopus.
Keywords: Sinusitis, fungal sinusitis, immunocompromised hosts