Clinical Characteristics of Allergic Fungal Sinusitis

Kim, A Young; Kim, Dong Hyun; Kim, Yong Min; Rha, Ki Sang

Abstract

BACKGROUND AND OBJECTIVES: The diagnosis of the allergic fungal sinusitis (AFS) can be established by demonstrating type I hypersensitivity, nasal polyposis, characteristic CT scans, eosinophilic mucin and a positive fungal stain of mucus. There are certain conditions may also present clinically just like AFS, but in these cases, neither the presence of fungus nor the allergy can be documented. Some authors termed this condition as "AFS-like syndrome". Whether the AFS-like syndrome is a spectrum of AFS or different disease entity remains unclear. The objective of this study was to analyze the clinical features of allergic fungal sinusitis and to compare clinical features of AFS with those of AFS-like syndrome.
SUBJECTS AND METHOD
Five patients with AFS and six patients with AFS-like syndromes were analyzed in terms of clinical manifestations, presence of associated diseases, radiologic findings, allergic test, treatment, and treatment outcome.
RESULTS
Patients with AFS were younger than those with AFS-like syndrome. All patients of AFS group had histories of allergic disease. Eighty percent of AFS group patients had unilateral lesions, while 18 percent of AFS-like syndrome patients had unilateral lesions. Serum total IgE was more elevated in AFS group. On CT scan, characteristic findings such as heterogeneous soft tissue density, erosion of bony septa, and expansion of sinus wall were more frequently found in AFS group. There was no difference in treatment outcome between two groups.
CONCLUSION
These results may suggest that AFS-like syndrome is a different disease entity from AFS.