Allergic Fungal Rhinosinusitis: A Study in a Tertiary Care Hospital in Malwa region of Punjab

Abstract

The study was conducted to study the occurrence and clinical presentation of allergic fungal rhinosinusitis
(AFRS), characterize the same, and correlate with the microbiological profile. Clinically suspected cases of
fungal rhinosinusitis (FRS) depending upon their clinical presentation, nasal endoscopy, and radiological
evidences were included. Relevant clinical samples were collected and subjected to direct microscopy
and culture and histopathological examination. 35 patients were diagnosed to have AFRS. The average
age was 28.4 years with a range of 18–48 years. Allergic mucin was seen in all the AFRS patients but
fungal hyphae were detected in only 20%. 80% of cases were positive for IgE. All the patients had nasal
obstruction followed by nasal discharge (62.8%). Polyps were seen in 95% (unilateral (48.57%) and bilateral
(45.71%)), deviated nasal septum was seen in 28.57%, and greenish yellow secretion was seen in 17.14%.
Direct microscopy and septate hyphae were positive in 71.42% of cases. 91.4% of cases were positive by
culture. 5.7% yielded mixed growth of A. flavus and A. niger. Prompt clinical suspicion with specific signs
and symptoms along with timely sampling of the adequate patient specimens and the optimal and timely
processing by microscopy and culture and histopathological examination is a must for early diagnosis and
management.