Acute Invasive Fungal Rhino-sinusitis: Clinical, Microbiological and Pathological Diagnosis

Background: Acute invasive fungal rhinosinusitis (AIFRS) is a challenging disorder that is diagnosed frequently in immunocompromised patients with very rapid progression.

Objective: to estimate the burden of AIFRS in Mansoura University Hospitals and to assess the mycological and clinicopathological profile of the disease.

Methods: Specimens were subjected to microbiological and histopathological examinations. Data about demographic characters, underlying diseases, presenting symptoms, signs, surgical interventions, and complications were collected.

Results: Twenty-two patients were diagnosed as AIFRS. Patients were 15 males and 7 females with age ranged from 14 to 55 years. The disease was prevalent among immunocompromised patients (100%). Hematological malignancies were the most common underlying conditions (68.18%), The remaining patients had disorders associated with immunosuppression as solid organ transplantation (18.18%) and non-insulin-dependent diabetes mellitus (13.64%). Culture results were positive only in 15 patients (68.18%). Aspergillus species (8/15) were the most common isolated organisms followed by Zygomycetes (7/15).

Conclusions: AIFRS continues to present a challenge to the otolaryngologist who must be highly suspicious at risk patient populations. Histopathological examination had high sensitivity. The isolated organisms were Aspergillus species and Rhizopus.