allergic fungal sinusitis


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allergic fungal sinusitis

A hypersensitivity reaction to fungal antigens which is seen in patients who are atopic or whose immune system is in overdrive; it is typically accompanied by asthma and nasal polyposis.

Clinical findings
Nasal airway obstruction; affected sinus contains firm, rubbery and thick mucoid material.

Lab
Raised IgE, eosinophilia.
 
Imaging
Sinus opacification, expansile remodelling, erosion, bony destruction and eventually ptosis, diplopia or intracranial expansion.

Microbiology
Aspergillus spp and dematiaceae—Alternaria, Bipolaris, Curvularia, Exserohilum.
 
Management
Remove mucus to restore mucociliary function, systemic steroids; antifungals are completely ineffective.

allergic fungal sinusitis

Chronic nasal obstruction with symptoms that include a runny nose and postnasal discharge that is caused by allergies to soil-based fungi (such as Curvularia or Alternaria). The condition is occasionally diagnosed in patients with an allergic history and nasal polyposis who have failed treatments for other sinus diseases. Tenacious mucus with a large number of eosinophils are often present.
See also: sinusitis
References in periodicals archive ?
No one knows how best to treat allergic fungal sinusitis.
No special attention was given to procuring as much sample as possible, and the procedure for obtaining specimens was the same for patients from both groups, since in most cases allergic fungal sinusitis was not a preoperative diagnosis in either group.
The immunologic mechanism behind allergic fungal sinusitis has been thought to be a combined type I and type III immune hypersensitivity response, mainly because of the similarity to mucoid impaction of the bronchus and acute bronchopulmonary fungal disease.
Following such thought, we agree that consideration should be given to changing the name of the entity from allergic fungal sinusitis to eosinophilic or allergic mucin sinusitis.
Allergic fungal sinusitis is a histopathologic diagnosis; paranasal mucocele is not.
Antifungal activity against allergic fungal sinusitis organisms.
Comprehensive management of allergic fungal sinusitis.
The clinical findings in patient 2, including her CT results, were suggestive of allergic fungal sinusitis, but both hematoxylin and eosin staining and Gomori methenamine silver staining demonstrated fungal hyphae in the sinus submucosal tissue and a granulomatous response directed against the fungal hyphae.