Backgound and Objectives : In patients with fungal sinusitis, purulent discharge from the
maxillary sinus is frequently observed and it responds to antibiotic treatment. Even though fungal
sinusitis is resolved after surgery, the purulent discharge continues in some cases. We aimed to
identify the pathogens of the purulent discharge in fungal sinusitis and to obtain information for
appropriate antibiotics through a sensitivity test.
Materials and Methods : Among 71 patients with fungal sinusitis of the maxillary sinus, purulent
secretions were found in 44 cases with fungal lesions and purulent secretion in the maxillary
sinus, purulent secretions were found in 44 patients (62％) during an endoscopic sinus surgery.
Endoscope-guided collection of the maxillary sinus secretions were performed and specimens were
sent to the laboratory for bacterial cultures and antibiotic sensitivity tests.
Results : Among 44 cases with fungal lesions and purulent secretion in the maxillary sinus,
bacteria were isolated in 27 cases(61.4％). Gram (＋) aerobes were recovered in 19 cases, and
Gram (-) aerobes were recovered in 16 cases. Mixed infection by Gram (＋) and Gram (-)
bacteria were observed in 8 patients. Anaerobic bacteria were not isolated. Among the Gram (＋)
aerobes, S. aureus was the most common organism (8 cases), while Enterobacter aerogenes was
the most common organism (7 cases) of the Gram (-) aerobes. In an antibiotic sensitivity test for
Gram (＋) bacteria, ciprofloxacin, bancomycin, and teicoplanin showed sensitivity over 85％. For
Gram (-) bacteria, ceftazidime, ciprofloxacin, ticarcillin, tobramycin, and imipenem showed
sensitivity over 90％.
Conclusion : In patients with fungal sinusitis, concomitant bacterial infections are identified in
more than half of the cases. Thus , Postoperative administration of appropriate antibiotics can be
justified in the treatment of fungal sinusitis.
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