Comparison of Fungal and Non-Fungal Rhinosinusitis by Culture-Based Analysis

Chih Hung Cha, Wei Chih Chen, Yu Ming Wang, Shao Chun Wu, Tai Jan Chiu, Ching Nung Wu, Yinshen Wee, Ching Shuen Wang, Yao Hsu Yang, Sheng Dean Luo

Research output: Contribution to journalArticlepeer-review


Background: Incidence of fungal rhinosinusitis has increased in recent few years. We investigated the differences in microbiological findings between patients with fungal and non-fungal rhinosinusitis by growing microbiological cultures from samples obtained from sinus surgery. Methods: Using the Chang Gung Research Database, we enrolled all chronic rhinosinusitis (CRS) patients who had ever undergone sinus surgery from 2001 to 2019 and had microbiological culture during sinus surgery. Enrolled patients were divided into fungal and non-fungal groups, based on fungal culture and surgical pathology. Results: A total of 898 patients were diagnosed with fungal rhinosinusitis and 2884 with non-fungal rhinosinusitis. The fungal group had a higher age distribution (56.9 ± 13.1 vs. 47.0 ± 14.9), a larger proportion of females (62.4% vs. 37.0%), more unilateral lesions (80.4% vs. 41.6%), a lower incidence of the need for revision surgery (3.6% vs. 6.0%, p = 0.004), and a higher proportion of Pseudomonas aeruginosa in the culture (14.3% vs. 4.6%, p < 0.001). Conclusions: This large-scale study showed that Pseudomonas aeruginosa are more commonly found in patients with fungal rhinosinusitis and in patients who needed revision surgery, suggesting that efforts aimed at eliminating Pseudomonas are needed in order to improve the disease outcomes of patients with fungal rhinosinusitis.

Original languageEnglish
Article number1368
JournalJournal of Personalized Medicine
Issue number9
Publication statusPublished - Sept 2023


  • chronic rhinosinusitis
  • fungal sinusitis
  • rhinosinusitis
  • sinus surgery

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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