Incidence and presentation of fungal sinusitis in patient diagnosed with chronic rhinosinusitis.

Significant number of patients diagnosed with chronic rhino sinusitis often tend to have a final diagnosis of fungal sinusitis. We wanted to find out (a) The incidence of patients with fungal sinusitis in those patients who were initially diagnosed as chronic rhinosinusitis. (b) The presentation of fungal sinusitis patients who were initially diagnosed as CRS. Retrospective chart review of 242 patients diagnosed as CRS from May 2006 to April 2009. The various symptoms and signs of those diagnosed initially as CRS, who were then diagnosed as fungal sinusitis were tabulated. Radiological and serological investigations were then analyzed. The microbiology of various species that were cultured in those identified as fungal sinusitis were also presented. Out of 242 patients diagnosed with CRS, 67 patients had clinical and radiological evidence of fungal sinusitis but only 24 of these patients had fungal organisms identified. Majority of them were Aspergillus fumigatus. Clinical suspicion of fungal sinusitis should be made in those patients presenting with CRS with the following signs and symptoms of nasal obstruction, discharge and polyps. Most of those fungus were Aspergillus fumigatus and responded well to treatment.