Research Article
Environmental Risk Factors in Patients with
Noninvasive Fungal Sinusitis
Badr Eldin Mostafa, Mohammed M. K. El Sharnoubi,
Hesham A. A. El-Sersy, and Mohammed S. M. Mahmoud
Department of Otorhinolaryngology, Head and Neck Surgery, Ain-Shams University Faculty of Medicine, Cairo, Egypt
Correspondence should be addressed to Badr Eldin Mostafa; bemostafa@gmail.com
Received 3 December 2015; Revised 2 March 2016; Accepted 14 April 2016
Academic Editor: Marek Sanak
Copyright © 2016 Badr Eldin Mostafa et al. his is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Objective. he aim of our study was to try to determine the possible environmental risk factors for noninvasive fungal sinusitis in
Egyptian patients. Methods. his is a prospective epidemiological case control study on the environmental risk factors of noninvasive
fungal sinusitis. It included 60 patients and 100 age and sex matched controls. Results. here was a statistically signiicant relation
between apartment loor, surface area, exposure to dust, exposure to cockroaches, poor air conditioning, and fungal sinusitis. Yet,
no statistical signiicance was found between allergy related occupations, exposure to animals or plants, although their percentages
were higher among cases, smoking, and urban or rural residence. Conclusion. We suggest that for patients with noninvasive fungal
sinusitis a change in their living environment must be implied with better exposure to sunlight, larger well ventilated homes, proper
cleaning of dust and cockroach extermination, and if possible the judicious use of air conditioners.
1. Introduction
Fungal sinusitis was considered as a rare geographically
localized disease until a worldwide increase was reported
in the last two decades [1]. Although fungal superinfections
are common in immunocompromised individuals, there has
been a surge in the afection of immunocompetent hosts
[2]. Fungal disease of the nose and paranasal sinuses can
be classiied based on the clinical, radiologic, and histologic
manifestations of the host-pathogen relationship [3]. he
most commonly accepted classiication system divides fungal
rhinosinusitis into invasive and noninvasive diseases based
on histopathologic evidence of fungal elements penetrating
host tissue. hese may be further subdivided into ive distinct
entities along the immunologic spectrum. Saprophytic fungal
infestation (SFI), sinus fungus ball (SFB), and allergic fungal
rhinosinusitis (AFRS) are fungal disease manifestations in
the absence of fungal invasion of host tissue. Acute fulmi-
nant invasive fungal rhinosinusitis (AFIFS), chronic invasive
fungal rhinosinusitis (CIFS), and granulomatous invasive
fungal rhinosinusitis (GIFS) exhibit histopathologic evidence
of hyphal forms within sinus mucosa, submucosa, blood
vessels, or bone [4].
he true reasons for this increase are not apparent
and may be a combination of environmental factors as
well as a higher index of suspicion amongst physicians.
he predilection of allergic fungal rhinosinusitis (AFRS) for
certain populations revealed some racial [5], socioeconomic
[6, 7], and geographical factors [8] or housing diferences
[9, 10]. he aim of our study was to try to determine the
possible environmental risk factors for noninvasive fungal
sinusitis in Egyptian patients.
2. Patients and Methods
his is a prospective epidemiological case control study
on the environmental risk factors of noninvasive fungal
sinusitis. It was conducted at Ain-Shams University Faculty
of Medicine between January 2013 and June 2014. he study
included 60 patients and 100 age and sex matched controls.
It was approved by the Local Ethical Committee (Ain-Shams
University Faculty of Medicine IRB ENT-7124/6/13).
Hindawi Publishing Corporation
Scientifica
Volume 2016, Article ID 5491694, 5 pages
http://dx.doi.org/10.1155/2016/5491694