Microbiology of rhinosinusitis in immunosupressed patients from the University Hospital

ABSTRACT: Immunosuppressed patients are often susceptible to upper airway infections, especially those of the paranasal sinuses. These can sometimes jeopardize treatment success and even lead to a fatal outcome. OBJECTIVE: To study the paranasal microbiology of immunosuppressed patients with clinical evidence of rhinosinusitis, and compare it with that from immunocompetent patients. MATERIAL AND METHOD: Retrospective study, in which 42 immunosuppressed and 16 immunocompetent patients were selected. All had clinically evident acute or recurrent rhinosinusitis and were submitted to ethmoidal or sphenoid sinusectomy or maxillary sinus puncture to gather material for microbiological cultures. RESULTS: There were 92% positive cultures, and 21% were negative. Of the positive cultures, 38% were bacterial, with P. aeruginosa being the most frequent agent; 64% were fungal, which occurred in the most immunocompromised patients. In the immunocompetent group, there were 62.5% positive cultures and 37.5% negative ones. All the positive ones were bacterial, with no fungi. CONCLUSION: Transplant recipients were prone to develop bacterial rhinosinusitis by Gram positive and Gram negative agents, the most common of the latter being Pseudomonas aeruginosa. Fungal infections occurred in the severely immunosuppressed, and it was absent in immunocompetent patients.