TO DETERMINE THE VARIOUS CLINICAL PRESENTATIONS, UNDERLYING IMMUNOCOMPROMISED CONDITION, COMPLICATION OF ACUTE INVASIVE FUNGAL RHINOSINUSITIS (AIFRS): AN OBSERVATIONAL STUDY.

Abhiniti ,Pawan Kumar Lal

doi:10.32553/ijmbs.v4i6.1343

Abstract

Aim: to determine the various clinical presentations, underlying immune-compromised condition, complication of acute invasive fungal rhinosinusitis (AIFRS). Materials and Methods: The present prospective observational study was conducted in the Department of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India. Among 40 patients of acute invasive fungal sinusitis that underwent treatment as inpatient basis. Nasal swabs from the middle meatus were subjected to potassium hydroxide mount and if fungal elements were identified, then fungal culture was done. Post-operatively, tissue removed from the sinuses was sent for histopathological examinations. Results: majority of the patients were male 57.5% and rest 42.5% were female. Patients having Diabetes Mellitus were found to be more susceptible to acute and invasive fungal sinusitis. The common presenting symptoms were nasal obstruction followed by rhinorrhea, epistaxis, headache, fever, facial swelling. Most common complication reported in this study was Cavernous sinus thrombosis 11 (27.5%). Conclusion: acute invasive fungal sinusitis is most common in immunocompromised patients, with the highest incidence in patients with uncontrolled diabetes mellitus. The most consistent finding of acute invasive fungal sinusitis was mucosal necrosis and black crust/debris. Keywords: acute invasive fungal sinusitis, diabetes mellitus, cavernous sinus thrombosis

Highlights

Fungal infections are one of the four major microbiological sub-groups
Most common complication reported in this study was Cavernous sinus thrombosis 11 (27.5%)
Conclusion: acute invasive fungal sinusitis is most common in immunocompromised patients, with the highest incidence in patients with uncontrolled diabetes mellitus

Summary

Introduction

Fungal infections are one of the four major microbiological sub-groups. As with bacteria, viruses and parasites, there are many thousand different types of fungi. A much smaller number are commonly clinically relevant microorganisms (20–25).[1,2] The most commonly encountered fungal species in medical practice are Candida species and Aspergillus species.[3] The less commonly encountered, but known for their invasive potential, are fungi of the Zygomycota order. These fungi are often implicated in immune-compromised individuals, as in the case of Mucormycosis.[4] Fungal spores are abundant in the atmosphere and so readily encounter anatomical structures relevant to ENT surgeons. These fungi, only develop pathological potential if the environment is suitable for this

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