Evaluation of CT Imaging and Microbiological Culture in Diagnosing Sinonasal Fungal Infections

Abstract

Background: Sinonasal fungal infections are increasingly recognized causes of chronic rhinosinusitis, particularly among immunocompromised individuals. Early diagnosis is crucial because invasive fungal infections can lead to significant morbidity and mortality. Computed tomography (CT) imaging and microbiological culture are commonly employed diagnostic modalities.
Aim: To evaluate the diagnostic utility of CT imaging and microbiological culture in patients with suspected sinonasal fungal infections.
Methods: A prospective study was conducted at Patna Medical College Hospital from July 2024 to June 2025. A total of 75 patients with clinically suspected sinonasal fungal infections underwent CT imaging and microbiological culture. Histopathological examination served as the reference standard. Diagnostic performance, fungal spectrum, and radiological findings were analyzed.
Results: Among 75 patients, fungal infection was confirmed in 52 (69.3%) cases. CT imaging demonstrated a sensitivity of 90.4% and specificity of 73.9%, whereas microbiological culture showed a sensitivity of 80.8% and specificity of 95.7%. Aspergillus species were the most frequently isolated fungi (53.8%), followed by Mucor species (28.8%). Hyperdense sinus opacification and bony erosion were significantly associated with fungal infection (p<0.001).
Conclusion: CT imaging is highly sensitive for detecting sinonasal fungal infections, while microbiological culture offers superior specificity. Combined use of radiological and microbiological methods significantly improves diagnostic accuracy.