Prevalence of fungal rhinosinusitis among patients with chronic rhinosinusitis from Iran

Abstract

Summary Objective In the present study, we evaluated the occurrence of fungal rhinosinusitis (FRS) and those causative agents in patients with chronic rhinosinusitis (CRS) from Sari city, the capital of Mazandaran, a northern province of Iran. Patients and methods During one year, we studied FRS in 50 consecutive patients with CRS undergoing endoscopic sinus surgery at Boo Ali hospital from Sari city, Iran. Surgical sinus specimens were analyzed by histopathological and mycological methods. These samples were also processed for fungal culture. Total serum IgE was evaluated in all patients. Results Nasal obstruction and congestion was the commonest (96.0%) clinical presentation. Out of 50 patients, 70.0% and 40.0% patients were positive for fungi by microscopic and culture methods, respectively. Aspergillus (45.0%) was the commonest isolated fungi. Twelve (24.0%) patients showed allergic fungal rhinosinusitis (AFRS). Nasal polyps, history of atopy and eosinophilic mucin were seen in all patients with AFRS. Three (6.0%) patients met criteria for sinus fungal ball. Aspergillus was the most prevalent isolated fungi from all categories of FRS. Conclusion In concordant to other studies from warm and humid regions, we also showed that FRS is a common disorder in patients with CRS and Aspergillus as the prevalent isolated fungi in these patients. Sinonasal polyps, history of atopy and eosinophilic mucin showed strong association with AFRS, therefore, using of these items as important criteria in diagnosis of AFRS are emphasized.