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.