Fungal sinusitis


Arunaloke Chakrabarti (


The objectives of the working group are:

  1. To assess the prevalence of fungal rhinosinusitis (FRS) among patients with chronic rhinosinusitis (CRS).
  2. To develop consensus on the categorization of FRS after resolving the controversies
  3. To develop management protocol for each category of FRS
  4. To develop co-operative research in the field of FRS


The working group estimated the burden of fungal rhinosinusitis in rural India and the paper has been published (Mycoses 2015; see below)

The working group consistently worked on the pathogenesis of fungal rhinosinusitis to understand the different categories of the disease. The highlights of the studies are as follows:

  • Immune response in allergic fungal rhinosinusitis FRS depends on locally inciting fungi rather than A. alternata in all instances, and the categorization of this group appears to be arbitrary (Med Mycol 2015; see below)
  • The issue of what triggers an allergic reaction: the fungal allergens and bacterial enterotoxin both can directly interact with nasal epithelial cells through pattern recognition receptors. The activated nasal epithelial cells release Th2 cytokines in nasal tissue; these cytokines induce M2 polarisation of macrophage leading to defective mucosal immunity and possibly predispose these individuals to chronic eosinophilic inflammation.


Chakrabarti et al Mycoses 2015; 58: 294-302 (Link here to the article)

Kale et al. Med Mycol 2015; 53: 387-395 (Link here to the article)