The prevalence of fungal infections in unilateral abnormal sinus imaging

Background: Rhinosinusitis is a common disease which may involve paranasal sinuses unilaterally or bilaterally. Bilateral paranasal sinus infection is more prevalent, and mostly caused by viruses, bacteria and fungi respectively. Unilateral rhinosinusitis is found infrequently and is mostly caused by bacteria and fungi.

Objectives: We studied the prevalence and types of fungal infection, and types of rhinosinusitis, in patients with unilateral abnormal sinus imaging

Methodology: A descriptive study with prospective data collection from 44 patients with unilateral abnormal sinus imaging, who were diagnosed with rhinosinusitis in Srinagarind hospital, Khon Kaen University, Thailand between August 2005 and August 2007.

Results: The prevalence of fungal infection in unilateral rhinosinusitis was 16/41 (39.0 %, 95% CI 24.1-53.9). Bacterial infection was found in 25/41 (61%, 95% CI 46.1-75.9). Three patients were lost to follow-up. Most cases with fungal infection in our study had fungal balls which were removed by endoscopic surgery.

Conclusion: A high prevalence of fungal infection was found in patients with unilateral rhinosinusitis. This group of patients who do not respond to antibiotics require further investigations to evaluate fungal infection and early surgical intervention should be considered.