Clinical characteristics and pathogen spectrum of patients with fungal rhinosinusitis and risk factors for invasiveness in Northern China: a retrospective study (2015–2024)

作者：Na Li, Mengran Yang, Xiangyi Liu, Xiaobo Tian · 发表于：BMC Infectious Diseases · 年份：2026 · DOI：10.1186/s12879-026-14116-6 · 研究领域：Sinusitis and nasal conditions、Antifungal resistance and susceptibility、Infectious Diseases and Mycology

Abstract Background Fungal rhinosinusitis (FRS) is becoming increasingly common but remains underdiagnosed or misdiagnosed due to atypical symptoms in invasive cases and limited regional epidemiological data. The aim of this study was to systematically describe the pathogenic spectrum, clinical characteristics, and risk factors for invasive disease in patients with FRS in Northern China over the past decade. Methods This retrospective study included 511 patients diagnosed with FRS at a tertiary hospital in Northern China from January 2015 to December 2024. All cases were confirmed by histopathology and fungal culture. Patients were classified as invasive fungal rhinosinusitis (IFRS) or non-invasive fungal rhinosinusitis (NIFRS) based on histopathological evidence of tissue invasion. Demographic characteristics, clinical manifestations, underlying diseases, laboratory findings, and pathogen data were collected and analyzed. Multivariate logistic regression was used to identify independent risk factors for IFRS. Results Among 511 patients, 52 (10.2%) were classified as IFRS and 459 (89.8%) as NIFRS. Chronic infection predominated (93.3%), with the maxillary sinus being the most frequently involved site (86.7%). Aspergillus species were the predominant pathogens (64.6%), primarily Aspergillus fumigatus (25.8%) and Aspergillus flavus (25.6%). Bacterial co-infection was present in 47.2% of patients. Compared to NIFRS, IFRS patients had significantly higher frequencies of ocular sy...