Chronic Rhinosinusitis (CRS) is a group of multifactorial diseases characterised by inflammation of the mucosa of the nose and paranasal sinuses with a history of at least 12 weeks of persistent symptoms and signs despite maximal medical therapy. Fungi are being increasingly implicated in the etiopathology of chronic rhinosinusitis. Early diagnosis and accurate classification of fungal rhinosinusitis which depends on demonstration of fungus may help in directing appropriate anti-fungal therapy. Objectives: This study was undertaken to determine the prevalence of fungal agents involved in chronic rhinosinusitis (CRS) and to analyse its clinico-mycological profile. Fifty patients with clinical suspicion of CRS attending a tertiary care hospital during a 6 months period were included in this analysis. The sino-nasal specimens were collected from patients attending ENT department which included allergic mucin, mucopurulent exudate at sinus cavity, nasal exudate and tissue specimens collected by endoscopic sinus surgery; while a portion of surgically excised specimens were received in sterile normal saline, another part of the specimens in 10% formalin were sent to the histopathology laboratory. These were subjected to microscopy by KOH mount and fungal culture as per standard mycological technique. Tissue specimens were also subjected to histopathological examination for correlation and categorization of fungal rhinosinusitis (FRS). Male to female ratio was 1.27:1; age varied from 14 years to 64 years with majority of patients (66%) belonging to age group 21-40 years. The prevalence of FRS was 26%, and 76.9% of it was caused by Aspergillus spp. Aspergillus flavus (61.5%) was the most prevalent fungus isolated, followed by Aspergillus niger (15.3%), Mucor spp. (15.3%) and Curvularia spp. (7.6%) respectively. Non-invasive allergic fungal rhinosinusitis (AFRS) was the most common presentation (85%). FRS is a continuous spectrum of disease varying in presentation, treatment and long-term sequelae. Clinical suspicion of fungal sinusitis should be made in those patients presenting with CRS with the following signs and symptoms of nasal obstruction, discharge and polyps. Correct identification of the fungus remains essential for appropriate treatment.

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