Allergic Fungal Rhinosinusitis: A Study in a Tertiary Care Hospital in Malwa region of Punjab

Abstract

The study was conducted to study the occurrence and clinical presentation of allergic fungal rhinosinusitis(AFRS), characterize the same, and correlate with the microbiological profile. Clinically suspected cases offungal rhinosinusitis (FRS) depending upon their clinical presentation, nasal endoscopy, and radiologicalevidences were included. Relevant clinical samples were collected and subjected to direct microscopyand culture and histopathological examination. 35 patients were diagnosed to have AFRS. The averageage was 28.4 years with a range of 18–48 years. Allergic mucin was seen in all the AFRS patients butfungal hyphae were detected in only 20%. 80% of cases were positive for IgE. All the patients had nasalobstruction followed by nasal discharge (62.8%). Polyps were seen in 95% (unilateral (48.57%) and bilateral(45.71%)), deviated nasal septum was seen in 28.57%, and greenish yellow secretion was seen in 17.14%.Direct microscopy and septate hyphae were positive in 71.42% of cases. 91.4% of cases were positive byculture. 5.7% yielded mixed growth of A. flavus and A. niger. Prompt clinical suspicion with specific signsand symptoms along with timely sampling of the adequate patient specimens and the optimal and timelyprocessing by microscopy and culture and histopathological examination is a must for early diagnosis andmanagement.