Clinical and Mycological Profile of Fungal Rhinosinusitis: A Cross-Sectional Study

Abstract

Introduction: Fungal rhinosinusitis (FRS) is an important subtype of chronic rhinosinusitis, particularly in immunocompromised patients. It presents with varied clinical features and requires accurate diagnosis for effective management.

Aim: To evaluate the clinical and mycological profile of fungal rhinosinusitis in patients presenting to a tertiary care hospital.

Materials and Methods: This cross-sectional prospective study was conducted from January 2024 to December 2025, enrolling 83 patients with suspected FRS. Clinical evaluation, specimen collection (nasal exudates, swabs, biopsies, sinus pus), direct microscopy (KOH mount), and culture on Sabouraud Dextrose Agar were performed. Fungal isolates were identified using standard mycological techniques. Data were analyzed using descriptive statistics.

Results: The majority of patients were 41–50 years old (36.14%), with male predominance (60.24%). The most common symptoms were nasal discharge (69.88%) and nasal blockage (54.22%). Diabetes mellitus was the leading predisposing factor (55%). Culture positivity was 69.88%, compared to KOH positivity in 55.42% of culture-positive cases. Aspergillus niger was the most frequent isolate (26%), followed by Mucor (17%) and Candida albicans (13%). Biopsy and sinus pus samples yielded the highest positivity (88–100%).

Conclusion: FRS is most prevalent in middle-aged males with diabetes. Nasal discharge and obstruction are hallmark symptoms, while orbital involvement indicates invasive disease. Culture remains the gold standard for diagnosis, with Aspergillus species predominating. Deep tissue specimens provide superior diagnostic yield, emphasizing their importance in clinical practice.