Acute invasive fungal sinusitis (AIFRS) is most commonly caused by which organism, and what is the hallmark pathological feature?

• A Aspergillus fumigatus; granulomatous inflammation with giant cells
• B Candida albicans; hyphal invasion of sinus mucosa
• C Alternaria species; eosinophilic mucin with Charcot-Leyden crystals
• D Mucor/Rhizopus species; angioinvasion with tissue infarction and absence of acute inflammation ✓

Explanation

AIFRS in immunocompromised and diabetic patients is most commonly caused by Mucorales (Mucor, Rhizopus, Cunninghamella). The hallmark is angioinvasion with vessel thrombosis leading to tissue infarction; the absence of neutrophilic (acute) inflammatory response reflects the host's immunocompromised state. Aspergillus causes both invasive and non-invasive disease, but granulomatous disease is characteristic of chronic invasive aspergillosis. Eosinophilic mucin with Charcot-Leyden crystals is allergic fungal rhinosinusitis.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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