Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : July | Volume : 11 | Issue : 7 | Page : DC10 - DC12

Fungal Rhinosinusitis: Microbiological and Histopathological Perspective

Ajay Kumar Singh, Prashant Gupta, Nityaverma, Vineeta Khare, Abrar ahamad, Virendra Verma, S.P Agarwal

1. Associate Professor, Department of Pathology, King Georges Medical University, Lucknow, Uttar Pradesh, India. 2. Associate Professor, Department of Microbiology, King Georges Medical University, Lucknow, Uttar Pradesh, India. 3. Ph. D Scholar, Department of Microbiology, Santosh Medical University, Ghajiabad, Uttar Pradesh, India. 4. Associate Professor, Department of Microbiology, Eras Lucknow Medical College, Lucknow, Uttar Pradesh, India. 5. Ph. D Scholar, Department of Microbiology, King Georges Medical University, Lucknow, Uttar Pradesh, India. 6. Professor, Department of Ear, Nose and Throat, King Georges Medical University, Lucknow, Uttar Pradesh, India. 7. Professor, Department of Ear, Nose and Throat, King Georges Medical University, Lucknow, Uttar Pradesh, India.

Correspondence Address :
Dr. Prashant Gupta,
Associate Professor, Department of Microbiology, King George's Medical University, Lucknow-226003, Uttar Pradesh, India.
E-mail: prashantgupta46@hotmail.com

Abstract

Introduction: On the basis of histopathology Fungal Rhinosinusitis (FRS) is categorized into non-invasive (allergic fungal rhinosinusitis, fungal ball) and invasive (acute invasive, chronic invasive and granulomatous invasive fungal sinusitis). This differentiation helps to decide the treatment. Role of latest molecular methods such as PCR and conventional methods such as KOH microscopy and culture also needs to be evaluated. Therefore, in this study we planned to categorise fungal rhinosinusitis on the basis of histopathology and compare it with other methods such as PCR, culture and KOH microscopy.

Aim: To analyse fungal rhinosinusitis cases by both histopathologically and microbiologically.

Materials and Methods: A total of 76 clinically suspected fungal rhinosinusitis cases were included in the study. The tissue of suspected cases were processed and examined by KOH microscopy, histopathologically, culture and PCR. Histopathological examination was done by PAS, GMS and H&E stain.

Results: FRS was diagnosed in 37 (48.68%) cases out of 76 clinically suspected cases of FRS. In which 17 (22.3%) cases were positive by direct microscopy, 21 (27.6%) by culture, 27 (35.5%) by PCR and 14 (18.42%) by histopathology. Approximately 14 cases of FRS were classified according to histopathology; 10 (71.3%) as non-invasive FRS. Out of these 10, 9 (64.2%) were classified as AFRS and 1 (7.14%) as fungal ball. Only 4 cases (28.5%) were diagnosed with invasive FRS. Out of these 4 cases, 2 (14.2%) were of chronic invasive fungal rhinosinusitis, 1 (7.14%) was of granulomatous invasive fungal rhinosinusitis and 1 (7.14%) was of acute fulminant invasive fungal rhinosinusitis. Allergic Fungal Rhinosinusitis (AFRS) is the most common type of FRS. Aspergillus flavus was found to be the most common fungi causing FRS.

Conclusion: Diagnosis should not be based on the single method. It should be done by both histopathological and microbiological methods, especially for those cases which are difficult to diagnose.

Keywords

Allergy, Culture, Fungal ball, Histopathology

How to cite this article :

Ajay Kumar Singh, Prashant Gupta, Nityaverma, Vineeta Khare, Abrar ahamad, Virendra Verma, et al.. FUNGAL RHINOSINUSITIS: MICROBIOLOGICAL AND HISTOPATHOLOGICAL PERSPECTIVE. Journal of Clinical and Diagnostic Research [serial online] 2017 July [cited: 2017 Sep 20 ]; 11:DC10-DC12. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=July&volume=11&issue=7&page=DC10-DC12&id=10167

DOI and Others

DOI: 10.7860/JCDR/2017/25842.10167

Date of Submission: Dec 06, 2016
Date of Peer Review: Jan 07, 2017
Date of Acceptance: Apr 20, 2017
Date of Publishing: Jul 01, 2017

Financial OR OTHER COMPETING INTERESTS: None.

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