allergic fungal sinusitis


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