Diagnosis of Allergic Fungal Rhinosinusitis

Background: Allergic fungal sinusitis is a non-invasive disease, and accounts for approximately 6-8% of all chronic sinusitis requiring surgical intervention. As the treatment and prognosis of these disorders vary significantly, it is extremely important to recognize allergic fugal sinusitis and differentiate it from chronic sinusitis of bacterial and fungal origin. This prospective study evaluates the occurrence of allergic fungal rhinosinusitis in patients with chronic rhinosinusitis with or without polyposis, who were surgically treated in Khalili Hospital during one year. Methods: The study comprised 38 patients with chronic rhinosinusitis with or without polyposis as case and 10 patients with chronic rhinosinusitis as control. The diagnosis of allergic fungal sinusitis was based on analysis of clinical, radiological, histological, mycological, and immuno allergic criteria. Results: From a total of 38 patients, 9 were consistent with allergic fungal rhinosinusitis. Twenty-one patients had histological, clinical, and radiological findings suggestive of allergic fungal sinusitis but were negative for fungal culture. Some of these patients had characteristics that recently described as eosinophilic mucin rhinosinusitis. None of the control cases had histological or mycological evidence of allergic fungal sinusitis. Conclusion: 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.Iran J Med Sci 2006; 31(4): 200-203. Keywords ● Chronic bacterial sinusitis ● fungal sinusitis ● eosinophil ● nasal polyp