Otolaryngology Book

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Allergic Fungal Sinusitis

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

Allergic fungal sinusitis (C1827192)

Concepts Disease or Syndrome (T047)
SnomedCT 425011002
English Allergic fungal sinusitis (disorder), Allergic fungal sinusitis
Spanish sinusitis alérgica por hongos, sinusitis alérgica por hongos (trastorno)
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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