Prevalence of allergic fungal sinusitis among patients with nasal polyps

Abstract

BACKGROUND:Nasal polyposis is a common problem in the eastern province of Saudi Arabia. Since allergic fungal sinusitis (AFS) can present with unilateral or bilateral nasal polyps, it is important to be aware of the prevalence of AFS in patients with nasal polyps.PATIENTS AND METHODS:The medical records of 91 patients with nasal polyps admitted for functional endoscopic sinus surgery were reviewed. The diagnosis of AFS was considered if histopathology showed the presence of eosinophillic mucin-containing hyphae. The following data were collected: presence of associated asthma, IgE levels, grading of CT scan findings, and operative details.RESULTS:Histopathological diagnosis was positive for AFS in 11 of 91 patients 12.1%. There was a highly significant statistical difference in IgE levels between patients suffering AFS and chronic hyperplastic rhinosinusitis with nasal polyps (P<.0001). The overall incidence of recurrence of polypi was 50.5% (45 of 89 patients who had follow up for a minimum of one year) and the rate of recurrence in patients with AFS was 54.5% (6 of 11 patients with AFS). There was a significant direct relationship between the CT grading of nasal polyps and recurrence, with a recurrence rate of 60.7% (34 of 56) in patients with grade III nasal polyps.CONCLUSION:This study showed that the prevalence of AFS among patients with nasal polyps is 12.1%, and suggests that CT grading of nasal polyps can be used as a prognostic factor for disease recurrence.

Chronic fungal rhinosinusitis due to Aspergillus versicolor

“…Telmesani reported 12.1% (11/91) incidence of allergic fungal sinusitis among patients with nasal polyps. [4] CT scan of the patient showed multiple sinus involvement with marked opacity in left and right maxillary sinus. In study by Alrajhi et al, abnormalities of paranasal sinuses were noted on CT scan in all patients; all sinuses were involved in 61% of patients.…”

Fungal Infections in Patients with Chronic Rhinosinusitis in Al-Mukalla City, Yemen

“…Other study reported 6.7% prevalence of fungal sinusitis in Brazil (7) . The prevalence of allergic fungal sinusitis is about 12.1% among patients in Saudi Arabia (8) . .…”

Aspergillus Infections in the Head and Neck

“…Additionally, the presence of radiologic bony expansion or erosion, eosinophilic mucus without fungal invasion, and positive fungal cultures were identified in the majority of AFRS patients. AFRS can be caused by a variety of organisms, the most common of which include Aspergillus and Curvularia spp [14], and it remains a relatively common disease (10% to 30% of patients with nasal polyps also have AFRS) [15,16]. Yet, despite its prevalence, AFRS has often been difficult to diagnose accurately because on physical examination it is similar to chronic rhinosinusitis.…”