Mycological profile of fungal sinusitis: An audit of specimens over a 7-year period in a tertiary care hospital in Tamil Nadu

Pathology of Fungal Rhinosinusitis: A Review

“…Fungal cultures are often negative; however the most commonly isolated pathogen is Aspergillus sp. [3][4][5][6][8][9][10][11][12]. Treatment consists of surgical removal of the fungal material without the need for antifungal therapy.…”

“…Allergic FRS occurs in immunocompetent, atopic patients who present with symptoms of chronic rhinosinusitis (CRS) not responsive to standard conservative medical therapy. Allergic FRS is seen more commonly in warm humid climates such as in the southern and southeastern United States, India, and the Middle East, although a high incidence has also been reported in large urban areas in the Midwest and northeastern United States [3][4][5][6][10][11][12]. Grossly, the sinus contents from allergic FRS patients are described as inspissated, clay-like, mucin which is green, brown, or grayish in color.…”

“…or Aspergillus sp. depending on geography [3,4,6,[10][11][12]. In India as well as Saudi Arabia, Aspergillus flavus appears to be the most common fungal organism cultured in allergic FRS; however, in the US, particularly in the South and Southeast, the majority of allergic FRS cases (70-90 %) are associated with dematiaceous fungi [10][11][12][13][14][15][16]30].…”

“…Chronic forms of invasive FRS are rare in the United States but more common in India and the Middle East [10][11][12]. In fact, the recently published guidelines considered whether to separate these two entities; however, it was considered that these two forms of invasive FRS had enough clinical and pathological differences to keep them as separate entities [1,2].…”

“…The infection is characterized the presence of submucosal granulomatous inflammation, rare fungal hyphae, and extensive fibrosis [10][11][12]44] (Fig. 5).…”