Title : Importance of fungal sinusitis in diabetic patients
Abstract:
Fungal sinusitis usually is observed in immunocompromised individuals but may be appear in healthy people. Fungal sinusitis is appeared in invasive, non-invasive, allergic and mycetoma (aspergilloma) forms. Originally this disease was a most commonly descried in ketoacidosis poorly controlled diabetic patients. This study was been with the aim of characterized of Fungal sinusitis and identified the most commonly fungal agents in this infection in immunocompromised individuals and diabetic individuals. In this study 34 sinusitis patients attending to department of ENT, Emam Khomeiny Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran were evaluated. Fungal sinusitis was diagnosed based on clinical findings, functional endoscopic sinuses surgery (FESS) of nasal and paranasal sinuses, CTscan and MRI, Mycological and histopathological examinations. In histopathological and mycological examinations of tissue specimens endoscopic sinuses of nasal and paranasal, in 8 cases out of 34 cases was observed board, branching, nonseptate hyphae and in 7 cases else, septate hyphae and in cultured, Rhizomucor and Rhizopus and Aspergillus flavus and Aspergillus niger species were isolated. In this study fungal sinusitis was reported in individuals which were diabetic and immunosuppress such as kidney transplantation, leukemia and record of eye and nasal polyp surgery and allergic chronic sinusitis. Also one case deep hard palate fistula due to sinonasal Mucormycosis was reported in 15 year old girl, diabetic. We emphasize the importance of early clinical diagnosis and treatment with surgical debridement of infected tissue in nasal cavity and paranasal sinuses combined with Amphotricin B in special patients such as diabetic individuals as soon as possible.
Key words: Fungal sinusitis, Aspergillosis, Mucormycosis, paranasal sinuse, diabetic patients
