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A seven-year retrospective analysis of the clinicopathological and mycological manifestations of fungal rhinosinusitis in a single-centre tropical climate hospital

Published online by Cambridge University Press:  25 August 2017

L C Goh ,
E D Shakri ,
H Y Ong ,
S Mustakim ,
M M Shaariyah ,
W S J Ng  and
A B Zulkiflee
L C Goh*
Affiliation:
Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia
E D Shakri
Affiliation:
Department of Otorhinolaryngology, Tengku Ampuan Rahmah Hospital, Klang, Malaysia
H Y Ong
Affiliation:
Department of Otorhinolaryngology, Tengku Ampuan Rahmah Hospital, Klang, Malaysia
S Mustakim
Affiliation:
Department of Pathology, Tengku Ampuan Rahmah Hospital, Klang, Malaysia
M M Shaariyah
Affiliation:
Department of Otorhinolaryngology, Tengku Ampuan Rahmah Hospital, Klang, Malaysia
W S J Ng
Affiliation:
Department of Otorhinolaryngology, Tengku Ampuan Rahmah Hospital, Klang, Malaysia
A B Zulkiflee
Affiliation:
Department of Otorhinolaryngology, University of Malaya, Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Goh Liang Chye, Department of Otorhinolaryngology, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Wilayah Persekutuan, Malaysia Fax: +60 3 7955 6963 E-mail: [email protected]
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Abstract

Objective:

To evaluate the clinicopathological and mycological manifestations of fungal rhinosinusitis occurring in the Tengku Ampuan Rahimah Hospital, in Klang, Malaysia, which has a tropical climate.

Methods:

Records of patients treated from 2009 to 2016 were analysed retrospectively. Data from the records were indexed based on age, gender, clinical presentations, symptom duration, clinical signs and mycological growth.

Results:

Of 80 samples, 27 (33.75 per cent) had fungal growth. Sixteen patients were classified as having non-invasive fungal rhinosinusitis and 11 as having invasive fungal rhinosinusitis. The commonest clinical presentation was nasal polyposis in non-invasive fungal rhinosinusitis patients (p < 0.05) and ocular symptoms in invasive fungal rhinosinusitis patients (p < 0.05). The commonest organism was aspergillus sp. (p < 0.05) in non-invasive fungal rhinosinusitis and mucorales in invasive fungal rhinosinusitis.

Conclusion:

There is an almost equal distribution of both invasive and non-invasive fungal rhinosinusitis, as seen in some Asian countries. Invasive fungal rhinosinusitis, while slightly uncommon when compared to non-invasive fungal rhinosinusitis, is potentially life threatening, and may require early and extensive surgical debridement. The clinical presentation of nasal polyposis was often associated with non-invasive fungal rhinosinusitis, whereas ocular symptoms were more likely to be associated with invasive fungal rhinosinusitis.

Keywords

SinusitisRhinitisTropical ClimateFungus DiseaseMycologyMycosesMicrobiologyCross-Sectional Studies
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 9 , September 2017 , pp. 813 - 816
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Bent, JP 3rd, Kuhn, FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg 1994;111:580–8CrossRefGoogle ScholarPubMed
2 Goh, BS, Gendeh, BS, Rose, IM, Pit, S, Samad, SA. Prevalence of allergic fungal sinusitis in refractory chronic rhinosinusitis in adult Malaysians. Otolaryngol Head Neck Surg 2005;133:27–31 Google Scholar
3 Kontoyiannis, DP, Marr, KA, Park, BJ, Alexander, BD, Anaissie, EJ, Walsh, TJ et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis 2010;50:1091–100Google Scholar
4 Singh, N. Trends in the epidemiology of opportunistic fungal infections: predisposing factors and the impact of antimicrobial use practices. Clin Infect Dis 2001;33:1692–6Google Scholar
5 Schell, WA. Unusual fungal pathogens in fungal rhinosinusitis. Otolaryngol Clin North Am 2000;33:367–73CrossRefGoogle ScholarPubMed
6 Brandt, ME, Warnock, DW. Epidemiology, clinical manifestations, and therapy of infections caused by dematiaceous fungi. J Chemother 2003;15(suppl 2):36–47 CrossRefGoogle ScholarPubMed
7 DelGaudio, JM, Clemson, LA. An early detection protocol for invasive fungal sinusitis in neutropenic patients successfully reduces extent of disease at presentation and long term morbidity. Laryngoscope 2009;119:180–3Google Scholar
8 Valera, FC, do Lago, T, Tamashiro, E, Yassuda, CC, Silveira, F, Anselmo-Lima, WT. Prognosis of acute invasive fungal rhinosinusitis related to underlying disease. Int J Infect Dis 2011;15:e841–4 Google Scholar
9 Granville, L, Chirala, M, Cernoch, P, Ostrowski, M, Truong, LD. Fungal sinusitis: histologic spectrum and correlation with culture. Hum Pathol 2004;35:474–81Google Scholar
10 Das, A, Bal, A, Chakrabarti, A, Panda, N, Joshi, K. Spectrum of fungal rhinosinusitis; histopathologist's perspective. Histopathology 2009;54:854–9CrossRefGoogle ScholarPubMed
11 Soontrapa, P, Larbcharoensub, N, Luxameechanporn, T, Cheewaruangroj, W, Prakunhungsit, S, Sathapatayavong, B et al. Fungal rhinosinusitis: a retrospective analysis of clinicopathologic features and treatment outcomes at Ramathibodi Hospital. Southeast Asian J Trop Med Public Health 2010;41:442–9Google Scholar
12 Montone, KT, Livolsi, VA, Feldman, MD, Palmer, J, Chiu, AG, Lanza, DC et al. Fungal rhinosinusitis: a retrospective microbiologic and pathologic review of 400 patients at a single university medical centre. Int J Otolaryngol 2012;2012:684835 CrossRefGoogle Scholar
13 Challa, S, Uppin, SG, Hanumanthu, S, Panigrahi, MK, Purohit, AK, Sattaluri, S et al. Fungal rhinosinusitis: a clinicopathological study from South India. Eur Arch Otorhinolaryngol 2010;267:1239–45Google Scholar
14 Dufour, X, Kauffmann-Lacroix, C, Ferrie, JC, Goujon, JM, Rodier, MH, Klossek, JM. Paranasal sinus fungus ball: epidemiology, clinical features and diagnosis. A retrospective analysis of 173 cases from a single medical center in France, 1989–2002. Med Mycol 2006;44:61–7CrossRefGoogle ScholarPubMed
15 Panda, NK, Sharma, SC, Chakrabarti, A, Mann, SB. Paranasal sinus mycoses in north India. Mycoses 1998;41:281–6Google Scholar
16 Ebbens, FA, Fokkens, WJ. The mold conundrum in chronic rhinosinusitis: where do we stand today? Curr Allergy Asthma Rep 2008;8:93–101 CrossRefGoogle ScholarPubMed
17 Ebbens, FA, Georgalas, C, Fokkens, WJ. Fungus as the cause of chronic rhinosinusitis: the case remains unproven. Curr Opin Otolaryngol Head Neck Surg 2009;17:43–9Google Scholar