Allergic Aspergillus Sinusitis

Allergic aspergillus sinusitis has recently been increasingly recognized. Five cases are discussed. All presented with proptosis, signs and symptoms of allergic rhinitis and radiological evidence of expansile masses with calcification and bony erosions involving multiple sinuses. Greenish cheesy material was seen at surgery. Histologically the lesions contained eosinophils, Charcot-Lyden crystals and fungal septate hyphae. Aspergillus fumigatus was grown from all cases. Surgical removal with drainage and aeration were performed. The follow-up period ranged between three to 18 months. Recurrence occurred in one patient.Allergic aspergillus sinusitis can mimic malignant disease and should be considered in the differential diagnosis of lesions involving multiple sinuses. It should also be considered in all cases of proptosis.

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“…Topical steroids are advised in all cases (Jonathan et al, 1989). Clinical and radiological follow-up is important (Jackson et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

Allergic aspergillus sinusitis with proptosis

et al. 1992

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“…Invasive aspergillus sinusitis is characterized by spread of fungal mycelium from sinus air spaces into adjacent structures with tissue necrosis, chronic inflammation and fibrosis (Hora, 1965;Jackson et al, 1987;Milroy et al, 1989). Blood vessels may be invaded producing thrombosis and infarction (Bodey and Vartivarian, 1989), In these cases fungal hyphal elements are always identified on deep biopsy, within the submucosa or bone (Washburn etal, 1988).…”

Section: Introductionmentioning

confidence: 99%

An algorithmic approach to aspergillus sinusitis

Carpentier¹,

Ramamurthy²,

Denning

et al. 1994

J. Laryngol. Otol.

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The effective management of paranasal sinus aspergillosis requires early diagnosis, histological classification, surgery and where appropriate, chemotherapy. Fungal sinusitis may be easily missed unless a high index of suspicion is maintained and specific culture and histology requested. The disease is classified into invasive and noninvasive types, each being divided into two subgroups: invasive aspergillosis may be either fulminant or indolent and noninvasive disease localized or allergic. The literature is reviewed and an algorithmic approach to aspergillus sinusitis proposed. The importance of histologically differentiating invasive from noninvasive aspergillosis prior to selecting the appropriate treatment options is stressed. CT scan should precede definitive surgery, and be used in follow-up. Close and prolonged follow-up is essential.

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“…The clinical description of AFRS evolved from an analogous clinical entity in the lower airway, allergic bronchopulmonary aspergillosis (ABPA), and described AFRS as an IgE-driven disease. 16 , 17 Certainly, the sine qua non features of AFRS are the presence of fungus, IgE and systemic hypersensitivity to fungal antigen. Early studies investigating the etiology of AFRS supported this theory by identifying the presence of fungal-specific IgE and IgG in patients with AFRS.…”

Section: Molecular and Immune Profiling In Afrsmentioning

confidence: 99%

Section: Molecular and Immune Profiling In Afrsmentioning

confidence: 99%

Current understanding of allergic fungal rhinosinusitis

Tyler

Luong

2018

World j. otorhinolaryngol.-head neck surg.

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Studying the pathophysiology of allergic fungal rhinosinusitis (AFRS) has proved challenging. While this clinical entity is easily distinguishable based on the clinical criteria set forth by Bent and Kuhn twenty-five years ago, studies examining type 2 inflammatory profiles in AFRS can make it seem more alike other CRS subtypes than it is different. Still, evolving research seems to clearly delineate this subtype from others in CRS. This review will critically evaluate the evolution of research examining the pathophysiology of AFRS and will conclude with a summary of the special considerations in the management of this fascinating disease.

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Allergic Aspergillus Sinusitis

Cited by 14 publications

References 0 publications

Allergic aspergillus sinusitis with proptosis

Allergic aspergillus sinusitis with proptosis

An algorithmic approach to aspergillus sinusitis

Current understanding of allergic fungal rhinosinusitis

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