P275 Dematiaceous fungi as a rare cause of fungal sinusitis in a tertiary care center

POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: OBJECTIVES: To discuss the occurrence and diagnosis of dematiaceous fungi as a causative organisms of fungal sinusitis in patients at a tertiary care center in North India. Since there is limited data on its prevalence, this study was aimed to know the non-Aspergillus causes of fungal sinusitis focusing on the dematiaceous fungi. METHODS: A total of 451 nasal biopsy samples, from the department of pulmonary medicine ward and ICU were received over a period of 3 years, from January 2019 to December 2021. The samples were subjected to conventional mycological diagnostic techniques including direct epifluorescence and light microscopy, culture on solid media and visual identification of growth in culture using lactophenol cotton blue mounts. RESULTS: Out of 451 samples, no fungi were isolated from 299 samples (66.29%), Aspergillus spp from 63 samples (13.96%), dematiaceous fungi from 10 samples (2.21%), and other fungi from 79 samples (17.5%). Among the dematiaceous fungi isolated, 7 isolates were identified as Alternaria spp. (70%) and 3 isolates were identified as Curvularia species (30%) and described. CONCLUSION: Most reported cases of allergic and invasive sinusitis were attributed to Aspergillus spp. However, in the current study, dematiaceous ‘black’ fungi like Alternaria and Curvularia, were also identified as causes of fungal sinusitis in both immunocompromised and immunocompetent individuals, showing an increasing pathogenic spectrum. Hence a high index of clinical suspicion and appropriate laboratory diagnosis assists in initiating appropriate treatment such as surgical debridement, reducing immunosuppression, and antifungal treatment with newer azoles.