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Etiological Agents

Though species of Aspergillus is isolated from majority of fungal sinusitis, a vast array of fungi including Candida spp., Cryptococcus neoformans, Histoplasma capsulatum, Pseudallescheria boydii, Sporothrix schenckii, several phaeoid mycelial fungi, zygomycetes, hyalohyphomycetes etc. are reported as causative agents of fungal sinusitis (1). Any relationship of environmental spore count colonization in nasal mucosa and causation of sinusitis is yet to be determined.

From patients with AFRS, phaeoid mycelial fungi including Bipolaris, Curvularia, Exserohilum and Alternaria species are commonly isolated from sinus tissue, followed by Aspergillus sp. (2). In contrast, A. flavus is commonly isolated from patients with AFRS in Indian scenario (3, 4). It would be interesting to know the reasons for this contrasting observation.

References

  1. Chakrabarti A, Das A, Panda NK. Overview of fungal rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2004; 56: 251-8.
  2. Schubert MS. Allergic fungal sinusitis: pathogenesis and management strategies. Drugs 2004; 64: 363-74.
  3. Thakar A, Sarkar C, Dhiwakar M, Bahadur S, Dahiya S. Allergic fungal sinusitis: expanding the clinicopathological spectrum. Otolaryngol Head Neck Surg 2004; 130: 209-16.
  4. Saravanan K, Panda NK, Chakrabarti A, Das A, Bapuraj RJ. Allergic fungal rhinosinusitis: an attempt to resolve the diagnostic dilemma. Arch Otolaryngol Head Neck Surg 2006; 132: 173-8.
 
     
       
       
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