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.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

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
Medical Dictionary, © 2009 Farlex and Partners
References in periodicals archive ?
The syndrome has been reported in patients using humidification reservoirs for C-Pap therapy and it can coexist with allergic fungal sinusitis. It is also more common in humid, coastal areas.
Telmesani Prevalence of allergic fungal sinusitis among patients with nasal polyps Ann Saudi Med.
Is the absence of fungus indicative of a separate entity, distinct from allergic fungal sinusitis? There is evidence, according to Ferguson, (7) that this is indeed the case.
Allergic fungal sinusitis is a histopathologic diagnosis; paranasal mucocele is not.
Patients and Methods: In a prospective clinical study carried out in tertiary health care centre of central India for a period of 2 years, 60 patients who underwent FESS for Allergic Fungal Sinusitis were followed up for a period of 6 months.
DISCUSSION: Allergic fungal sinusitis is being increasingly seen in various parts of the world with higher incidence in Southwestern states of the USA, 7 Sudan, northern India, (8, 9) and Saudi Arabia.
Fluconazole nasal spray in the treatment of allergic fungal sinusitis: A pilot study.
The authors describe a prospective pilot study designed to investigate the use of topical nasal antifungal spray in addition to systemic steroids and itraconazole in the treatment of allergic fungal sinusitis. Sixteen patients with a history of allergic fungal sinusitis were given fluconazole nasal spray and followed for 3 months.
On the other hand, allergic fungal sinusitis is thought to be the result of an atopic reaction to the causative fungus, and most patients with fungus balls are immunocompetent.
(24,25) It is extremely important to recognize allergic fungal sinusitis and to be able to differentiate it from other forms of sinusitis, because the treatments and prognoses for these disorders differ significantly.
This case illustrates the fact that A flavus can colonize nasopharyngeal tissue in the absence of immunocompromise or allergic fungal sinusitis and that it can be associated with oxalosis.
The panel members agree that middle turbinate resection, either subtotal or total, might be indicated for patients who have a paradoxically bent middle turbinate, a concha bullosa, or significant polyposis, particularly patients who have eosinophilic mucinous rhinosinusitis or allergic fungal sinusitis. We also agree that partial inferior turbinate resection is also indicated when the inferior turbinate is part of the problem.