Allergic Fungal rhino-sinusitis frequency in chronic rhino-sinusitis patients and accuracy of fungal culture in its diagnosis

Allergic Fungal rhino-sinusitis

  • Nukhbat Ullah Awan, Dr King Edward medical University, Lahore
  • Khalid Muneer Cheema, Prof Dr King Edward medical University, Lahore
  • Fatima Naumeri, Dr King Edward Medical University, Lahore https://orcid.org/0000-0003-3532-5553
  • Samina Qamar, Dr King Edward medical University, Lahore
Keywords: Allergic fungal rhino-sinusitis, fungal culture, Bent and Kuhn diagnostic criteria, chronic rhino-sinusitis

Abstract

Objective: To determine the frequency of Allergic Fungal Rhino-sinusitis (AFRS) in Chronic Rhino-sinusitis (CRS) patients and the accuracy of fungal culture in diagnosing AFRS.

Methods: Immunocompetent patients with CRS and without invasive fungal rhino-sinusitis presenting over a period of 3 years in ENT department of Mayo Hospital, from April 2014 to September 2017 were included in the study. AFRS was diagnosed clinically and on Bent and Kuhn diagnostic criteria. All patients underwent endoscopic sinus surgery. Removed tissue histopathology and fungal culture was done. Diagnostic accuracy of fungal culture in AFRS patients was determined.

Results: Out of 216 patients of CRS, 45 (20.8%) had AFRS. Mean age of patients diagnosed with AFRS was 29.49±9.16. Out of 45 patients, 26 were male and 19 were female. Nasal polyps were present in 45 (100%) patients, fungal stain was positive in 39(86.7%). CT scan showed sinus expansion in 28(62.2%) patients, heterogeneous opacity in 45(100%) patients and bone destruction in 13(28.9%). Presence of Allergic Mucin was seen in 45(100%) patients, high IgE levels in 36(80.0%), eosinophilia in 21(46.7%), presence of Charcot Leyden crystals in 27(60.0%). Asymmetrical involvement of sinuses was seen in 30 (66.7%) and co-existent asthma was seen in 18(40.0%). Fungal culture positive patients were 25(55.6%). Diagnostic accuracy of fungal culture was 91.6%.

Conclusion: Fungal culture has a key role in confirming diagnosis of AFRS. We also noted that frequency of AFRS is increasing in CRS patients.

doi: https://doi.org/10.12669/pjms.36.3.1661

How to cite this:
Awan NU, Cheema KM, Naumeri F, Qamar S. Allergic Fungal rhino-sinusitis frequency in chronic rhino-sinusitis patients and accuracy of fungal culture in its diagnosis. Pak J Med Sci. 2020;36(3):555-558. doi: https://doi.org/10.12669/pjms.36.3.1661

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Nukhbat Ullah Awan, Dr, King Edward medical University, Lahore

Assistant Professor, ENT Department Unit-II, King Edward medical University, Lahore

Khalid Muneer Cheema, Prof Dr, King Edward medical University, Lahore

Professor, ENT Department, Unit-II, King Edward Medical University, Lahore. 

Fatima Naumeri, Dr, King Edward Medical University, Lahore

Associate Professor, Pediatric surgery Department, King Edward Medical University, Lahore

Samina Qamar, Dr, King Edward medical University, Lahore

Assistant Professor, Department of Pathology, King Edward medical university, Lahore

Published
2020-03-04
Section
Original Articles