The diagnosis and incidence of allergic fungal sinusitis.

@article{Ponikau1999TheDA,
  title={The diagnosis and incidence of allergic fungal sinusitis.},
  author={J. Ponikau and D. Sherris and E. Kern and H. Homburger and E. Frigas and T. Gaffey and G. Roberts},
  journal={Mayo Clinic proceedings},
  year={1999},
  volume={74 9},
  pages={
          877-84
        }
}
OBJECTIVE To reevaluate the current criteria for diagnosing allergic fungal sinusitis (AFS) and determine the incidence of AFS in patients with chronic rhinosinusitis (CRS). METHODS This prospective study evaluated the incidence of AFS in 210 consecutive patients with CRS with or without polyposis, of whom 101 were treated surgically. Collecting and culturing fungi from nasal mucus require special handling, and novel methods are described. Surgical specimen handling emphasizes histologic… Expand
Allergic fungal sinusitis: radiological and microbiological features of 59 cases
TLDR
Allergic fungal sinusitis has been an underdiagnosed clinical entity and only increased awareness among physicians of fungal involvement will increase accuracy of diagnosis. Expand
Allergic fungal sinusitis (AFS) – earlier diagnosis and management
Aim: To evaluate the criteria for diagnosing allergic fungal sinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of mucosa. Methods: This is a prospectiveExpand
Prevalence of Allergic Fungal Sinusitis in Refractory Chronic Rhinosinusitis in Adult Malaysians
TLDR
This preliminary study suggests that AFS does exist in Malaysia, and proper handling of surgical specimens and accurate diagnosis by the pathologist and mycologist are essential. Expand
The role of fungi in the etiology of chronic rhinosinusitis: a prospective study.
TLDR
In certain susceptible individuals inhaled fungi may provoke an eosinophilic response, which varies from simple eos inophilic inflammation to classic allergic fungal sinusitis. Expand
Rate of allergic fungal etiology of chronic rhinosinusitis in Turkish population
TLDR
No significant correlation could be found between presence of intranasal fungus and type-1 hypersensitivity in patients with CRS, and fungal incidence was not as high as expected in Turkish patients withCRS. Expand
Role of fungi in allergic fungal sinusitis and chronic rhinosinusitis.
TLDR
The authors conclude that allergic fungal sinusitis (AFS) is significantly underdiagnosed and is in fact present in the majority of patients suffering from CRS, and suggest that immunoglobulin E (lgE)-mediated type I hyper­ sensitivity is not the dominant pathophy siological factor in AFS. Expand
Allergic fungal sinusitis. A naso-sinusal specific hyperreactivity for an infectious disease?
TLDR
Patients affected by the so-called "allergic fungal sinusitis" are analyzed to better define the relationship between fungi present in naso-sinusal secretions and the host's immunoreactivity and presence of fungi in nasal secretions of patients with AFS does not appear to be correlated with an allergic status to the isolated fungus. Expand
Diagnosis of Allergic Fungal Rhinosinusitis
TLDR
Nine (23.7%) patients had findings consistent with allergic fungal rhinosinusitis, however, more specific diagnostic tests such as skin test and specific IgE should be performed to confirm the diagnosis. Expand
Allergic fungal rhino sinusitis with granulomas: A new entity?
TLDR
Granulomas suggest a more severe disease with a trend toward the invasive fungal sinusitis and alerts the clinician regarding the nature of progression in AFS, which seems to be a part of a continuous spectrum of fungal Sinusitis rather than an allergic form as a distinct entity. Expand
[Allergic fungal sinusitis].
TLDR
Immunoglobulin E (IgE) antibody-mediated type I allergy may be involved in the pathogenesis of AFS, and an allergen provocation test against detected fungus was conducted in 2 patients from whom informed consent was obtained. Expand
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References

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Diagnosis of Allergic Fungal Sinusitis
  • J. Bent, F. Kuhn
  • Medicine
  • Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 1994
TLDR
For the diagnosis of allergic fungal sinusitis to be established, the following criteria should be met: type I hypersensitivity confirmed by history, skin tests, or serology; nasal polyposis; (3) characteristic computed tomography signs; (4) eosinophilic mucus without fungal invasion into sinus tissue; and (5) positive fungal stain of sinus contents removed during surgery. Expand
Diagnostic criteria for allergic fungal sinusitis.
TLDR
Five diagnostic criteria for allergic fungal sinusitis are proposed including the demonstration of the characteristic eosinophil-rich allergic mucin visually or histopathologically, a positive fungal stain or culture from the sinus at surgery, and the absence of immunodeficiency or diabetes. Expand
[Allergic fungal sinusitis: is this rare disease an allergy or infection?].
TLDR
The presented case showed a positive culture with negative immunological testing (RAST-positive and immediate cutaneous reactivity to fungal antigen), thus confirming the pathogenetic hypothesis of the saprophytic fungal growth in an atopic patient, and current therapeutic recommendations include complete exenteration of all allergic mucin. Expand
Evidence of ige‐mediated hypersensitivity in allergic fungal sinusitis
TLDR
Using a modified radioallergosorbent test to multiple fungal antigens, modified RAST testing can aid in the routine clinical diagnosis of AFS and it provides further serologic evidence for a type I hypersensitivity in the pathogenesis of A FS. Expand
Immunotherapy in the treatment of allergic fungal sinusitis.
  • R. Mabry, S. Manning, C. S. Mabry
  • Medicine
  • Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 1997
TLDR
The initial clinical impression is that this treatment regimen has resulted in significant reduction in the reaccumulation of crusts and allergic mucin within the sinuses, has led to a reduced use of topical nasal steroids, and has made systemic steroid therapy unnecessary, thereby improving the quality of life of the patient. Expand
Allergic Fungal Sinusitis
TLDR
Cytologic diagnosis of Allergic fungal sinusitis can be made from intraoperative sinus aspirates from the presence of AM and fungal elements, and AM and fungi provide presumptive evidence for a noninvasive, allergic fungal disease. Expand
Allergic Mucin Sinusitis without Fungus
TLDR
A subset of patients who present with a clinical picture similar to that of AFS patients in which fungus could not be demonstrated pathologically or on culture are identified. Expand
Immunotherapy for Allergic Fungal Sinusitis: The Second Year
  • R. Mabry, C. S. Mabry
  • Medicine
  • Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
  • 1997
TLDR
The experience indicates that the triad of adequate surgery, frequent follow-up and medical management, and immunotherapy with relevant fungal and nonfungal antigens represents an effective means of treating patients with allergic fungal sinusitis. Expand
Fungal sinusitis: an update.
TLDR
Recent advances in endoscopy and computed tomography have enhanced the understanding of fungal sinusitis; however, they remain diseases surrounded by controversy. Expand
Assessment of inflammation in noninfectious chronic maxillary sinusitis.
TLDR
Findings suggest that patients with CNAR and Sinusitis can be distinguished from patients with CAR and sinusitis, which resembles nonallergic rhinitis with eosinophilia syndrome. Expand
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