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Allergic Fungal Sinusitis
Aka: Allergic Fungal Sinusitis
- Epidemiology
- Affects immunocompetent children and young adults
- Higher Prevalence in warm, humid environments
- Accounts for 7% of Chronic Sinusitis requiring surgery
- Associated Conditions
- Asthma (33%)
- Aspirin sensitivity is not related
- Atopy
- Signs
- Nasal Polyps
- Chronic pansinusitis refractory to standard therapy
- Labs: Sinus mucus examination
- Charcot Leyden crystals
- Non-invasive hyphae
- Numerous Eosinophils
- Radiology: Sinus XRay Findings
- Complete opacification of multiple sinuses
- Extension beyond sinus
- Wall erosion of involved sinus
- Scattered areas of high attenuation
- Mucosal thickening
- Differential Diagnosis
- Sinonasal neoplasm
- Fungal Sinusitis
- Bacterial Acute Sinusitis
- Labs
- Total IgE elevated (often exceeds 1000)
- Management
- Surgical Debridement
- Immunotherapy with fungal and non-fungal Antigens
- Corticosteroids
- Irrigation and self-cleansing by patient
- References
- Kuhn (2000) Otolaryngol Clin North Am 33(2): 419-32 [PubMed]
- Mabry (2000) Otolaryngol Clin North Am 33(2): 433-40 [PubMed]
- Mabry (2000) Otolaryngol Clin North Am 33(2): 409-19 [PubMed]
- Mabry (1997) Otolaryngol Head Neck Surg 116: 31-5 [PubMed]
- Marple (1998) Am J Rhinol 12(4):263-8 [PubMed]