TO DETERMINE THE VARIOUS CLINICAL PRESENTATIONS, UNDERLYING IMMUNOCOMPROMISED CONDITION, COMPLICATION OF ACUTE INVASIVE FUNGAL RHINOSINUSITIS (AIFRS): AN OBSERVATIONAL STUDY.

Abstract

Aim: to determine the various clinical presentations, underlying immune-compromised condition, complication of acute invasive fungal rhinosinusitis (AIFRS).

Materials and Methods: The present prospective observational study was conducted in the Department of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India. Among 40 patients of acute invasive fungal sinusitis that underwent treatment as inpatient basis. Nasal swabs from the middle meatus were subjected to potassium hydroxide mount and if fungal elements were identified, then fungal culture was done. Post-operatively, tissue removed from the sinuses was sent for histopathological examinations.

Results: majority of the patients were male 57.5% and rest 42.5% were female. Patients having Diabetes Mellitus were found to be more susceptible to acute and invasive fungal sinusitis. The common presenting symptoms were nasal obstruction followed by rhinorrhea, epistaxis, headache, fever, facial swelling. Most common complication reported in this study was Cavernous sinus thrombosis 11 (27.5%).

Conclusion: acute invasive fungal sinusitis is most common in immunocompromised patients, with the highest incidence in patients with uncontrolled diabetes mellitus. The most consistent finding of acute invasive fungal sinusitis was mucosal necrosis and black crust/debris.

Keywords: acute invasive fungal sinusitis, diabetes mellitus, cavernous sinus thrombosis