Kaur Ravinder, Lavanya S, Khurana Nita, Gulati Achal, Dhakad Megh S
Department of Microbiology, Maulana Azad Medical College and Associated Hospitals, New Delhi 110002, India; Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India.
Department of Microbiology, Maulana Azad Medical College and Associated Hospitals, New Delhi 110002, India.
J Allergy (Cairo). 2016;2016:7698173. doi: 10.1155/2016/7698173. Epub 2016 Jan 24.
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.
本研究旨在探讨变应性真菌性鼻-鼻窦炎（AFRS）的发生情况及临床表现，对其进行特征描述，并与微生物学特征相关联。纳入根据临床表现、鼻内镜检查及影像学证据临床怀疑为真菌性鼻-鼻窦炎（FRS）的病例。收集相关临床样本，进行直接显微镜检查、培养及组织病理学检查。35例患者被诊断为AFRS。平均年龄为28.4岁，范围为18至48岁。所有AFRS患者均可见变应性黏液，但仅20%检测到真菌菌丝。80%的病例IgE呈阳性。所有患者均有鼻塞，其次为流涕（62.8%）。95%可见息肉（单侧（48.57%）和双侧（45.71%）），28.57%可见鼻中隔偏曲，17.14%可见黄绿色分泌物。71.42%的病例直接显微镜检查及有隔菌丝呈阳性。91.4%的病例培养呈阳性。5.7%培养出黄曲霉和黑曲霉混合生长。对于早期诊断和治疗，必须对具有特定体征和症状的患者进行及时临床怀疑，同时及时采集足够的患者标本，并通过显微镜检查、培养及组织病理学检查进行最佳且及时处理。
