Sinusitis: Risk Factors and Phenotyping.

J Clin Med

Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland.

Published: April 2024

AI Article Synopsis

  • The study investigated the risk factors for fungal rhinosinusitis (FRS) in patients with positive sinonasal cultures over a 9-year period in a continental climate.
  • Out of 86 patients, the research identified three groups: invasive FRS (mainly in immunocompromised patients), fungal ball disease (mostly symptom-free in the elderly), and chronic rhinosinusitis with fungus.
  • A potential new subgroup with nasal polyps and elevated IgE levels was noted, suggesting there might be a less severe type of allergic FRS in colder climates that is often underdiagnosed.

Article Abstract

: can cause fungal rhinosinusitis (FRS). We aimed to identify risk factors for sinonasal disease. Patients with a positive sinonasal mycological culture for species diagnosed in our hospital located in a continental climate were included in the 9-year retrospective study. Of the 86 patients, 3 had invasive FRS (IFRS), 51 had fungal ball (FB) disease, and 32 had chronic rhinosinusitis with fungus (CFRS). In the IFRS group, all patients had a malignancy and were immunocompromised. Allergies, allergic rhinitis, asthma, nasal polyps, and the use of inhaled and nasal steroids were more common in the CFRS group, and IgE levels were greater than those in the FB and IRFS groups ( < 0.05). FB disease is a relatively symptom-free single-sinus disease among elderly individuals, and IFRS is dominant among immunocompromised patients. We discovered a third patient group, predominantly with nasal polyps, atopy, asthma, and elevated blood IgE and eosinophils, that did not fulfill the allergic FRS (AFRS) criteria. It is possible that a less fulminant category of underdiagnosed AFRS exists in cold climates. Treatment with local debridement is usually sufficient for FRS, apart from IFRS, and relapses are not common in cold climates.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11084900PMC
http://dx.doi.org/10.3390/jcm13092579DOI Listing

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