Allergic Fungal Rhinosinusitis

Saravanan, K.; Panda, Naresh K.; Chakrabarti, Arunaloke; Das, Ashim; Bapuraj, Rajeev J.

doi:10.1001/archotol.132.2.173

Cited by 90 publications

(24 citation statements)

References 29 publications

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“…Aspergillus fumigatus accounted for 80% of the isolates in the former study and Shahid et al [11] reported Aspergillus fumigatus as the predominant species being isolated from 69.2% cases. Our findings are consistent with reports from other centres in India, in which isolation rate of A. flavus largely exceeded that of A. fumigatus , underscoring the importance of geographical differences in fungal recovery [12]. …”

Section: Discussionsupporting

confidence: 92%

Fungal colonization in patients with chronic respiratory diseases from Himalayan region of India

Biswas

Agarwal

Sindhwani

et al. 2010

Annals of Clinical Microbiology and Antimicrobials

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BackgroundWe screened patients with chronic respiratory diseases for microbiological and serological evidences of fungal colonisation; in order to determine its prevalence in this group of patients, examine potential clinical and radiological predictors of fungal colonisation and characterise fungal agents associated with individual diseases.MethodsBAL samples from 60 consecutive patients were subjected to microscopy and culture for fungal agents. Serum samples were analysed for precipitin antibodies to Aspergillus antigen and Candida cytoplasmic antigen. Statistical significance in the difference of fungal recovery between patient groups was determined using the Chi-square test.ResultsThe major diagnostic groups included patients with bronchogenic carcinoma (n = 31) and tubercular sequelae (n = 16). In all, 28 patients (46.7%) were culture-positive, with Candida and Aspergillus being recovered from 14 and 13 patients respectively. Twenty-one patients (35%) showed presence of precipitin antibodies. Patients with bronchogenic carcinoma showed increased predilection for colonisation with Aspergillus, while Candida was recovered more commonly in tubercular sequelae (p = 0.02). There was no statistically significant association between culture-positivity and specific risk factors/radiological findings.ConclusionThe point-prevalence of fungal colonization was almost 50%. The combination of fungal culture and serology helped improve diagnostic sensitivity. An interesting predilection was observed for Aspergillus and Candida, to preferentially infect patients with Bronchogenic carcinoma and Tubercular sequelae respectively. In absence of specific predictors, the possibility of fungal colonization needs to be explored actively in these patients.

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Section: Discussionsupporting

confidence: 92%

Fungal colonization in patients with chronic respiratory diseases from Himalayan region of India

Biswas

Agarwal

Sindhwani

et al. 2010

Annals of Clinical Microbiology and Antimicrobials

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“…6,7 In this study, out of 14 cases of fungal sinusitis only three (21%) were invasive mucormycosis, rest being allergic fungal rhinosinusitis (AFRS). All AFRS were due Aspergellous species and mucin in the specimen which is important in diagnosis was present in all cases.…”

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confidence: 72%

“…All AFRS were due Aspergellous species and mucin in the specimen which is important in diagnosis was present in all cases. 7 Ponikau et al, in their initial study using a sensitive detection method (nasal lavage), demonstrated that 93% of patients with CRS had fungi present in tissue specimens. 8 However, they also identified fungus in the nasal lavage from 100% of healthy volunteers, demonstrating the ubiquitous nature of these saprophytic fungi.…”

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confidence: 99%

Benign Sinonasal Masses: A Clinicopathological and Radiological Profile

Nepal

Chettri

et al. 2014

Kathmandu Univ. Med. J.

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“…Since rhinitis is an important predisposing factor for sinusitis, it appears that these patients may be at a greater risk for developing AAS. It has been suggested that 5 to 10% of patients with chronic rhinosinusitis go on to develop AFS [13, 21-23]. Human leukocyte antigen gene association, particularly with major histocompatibility class II regions, were observed in two-thirds of 44 patients with AFS from the United States [24].…”

Section: Introductionmentioning

confidence: 99%

Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis

Panjabi

Shah

2011

Asia Pacific Allergy

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Allergic Aspergillus sinusitis (AAS) is a three decade old clinicopathologic entity in which mucoid impaction akin to that of allergic bronchopulmonary aspergillosis (ABPA) occurs in the paranasal sinuses. Features such as radiographic evidence of pansinusitis, passage of nasal plugs and recurrent nasal polyposis in patients with an atopic background is suggestive of AAS. Histopathlogic confirmation from the inspissated mucus is a sine qua non for the diagnosis. Heterogeneous densities on computed tomography of the paranasal sinuses are caused by the 'allergic mucin' in the sinuses. Many patients give a history of having undergone multiple surgical procedures for symptomatic relief. The current approach to treatment appears to include an initial surgical debridement followed by postoperative oral corticosteroids for long durations. Although both ABPA and AAS are classified as Aspergillus-related hypersensitivity respiratory disorders, their co-occurrence appears to be an infrequently recognised phenomenon. This could perhaps be attributed to the fact that these two diseases are often treated by two different specialties. A high index of suspicion is required to establish the diagnoses of ABPA and AAS. All patients with asthma and/or rhinosinusitis along with sensitisation to Aspergillus antigens are at an increased risk of developing ABPA and/or AAS. ABPA must be excluded in all patients with AAS and vice versa. Early diagnosis and initiation of appropriate therapy could plausibly alter the course of the disease processes and prevent the possible development of long term sequelae.

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Allergic Fungal Rhinosinusitis

Cited by 90 publications

References 29 publications

Fungal colonization in patients with chronic respiratory diseases from Himalayan region of India

Fungal colonization in patients with chronic respiratory diseases from Himalayan region of India

Benign Sinonasal Masses: A Clinicopathological and Radiological Profile

Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis

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