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[Fungal allergy--part II]
Marek Niedoszytko1, Marta Chełmińska, Konrad Chełmiński
1Klinika Chorób Wewnetrznych, Endokrynologii i Zaburzeń Hemostazy Instytutu Chorób Wewnetrznych AM w Gdańsku.
Abstract:
Allergic reactions caused by fungi, may be present in the airways, skin, eyes, gastrointestinal tract, skin and to cause systemic reaction. Nasal symptoms react as allergic rhinitis. In a small group of patients the allergic fungal rhinosinusitis is present. It is important, because of the way of treatment, to differentiate the AFS from the other forms of chronic rhinosinusitis. The fungi may cause bronchial asthma, allergic bronchopulmonary aspergillosis and allergic alveolitis (hypersensitivity pneumonitis). Diagnostics of the allergic reactions caused by fungi includes routine allergological methods, mycologic culture and direct microscopic examination. The process of reaching the diagnosis of allergic fungal rhinosinusitis and allergic bronchopulmonary aspergillosis may require the CT and histopatologic examination. The treatment of fungal allergic reactions includes allergen avoidance, pharmacotherapy, antifungal treatment (id reactions) and surgical treatment (allergic fungal rhinosinusitis). The immunotherapy is a valuable, and accepted by the WHO therapy of the Cladosporium and Alternaria sensitive patients.
Insights
Fungal allergies can affect multiple body systems, leading to conditions like allergic rhinitis and asthma. Differentiating allergic fungal rhinosinusitis is crucial for effective treatment strategies.
Area of Science:
- Medical Mycology
- Allergology
- Immunology
Context:
- Fungal allergens can trigger diverse allergic reactions affecting the respiratory tract, skin, eyes, and gastrointestinal system.
- Allergic fungal rhinosinusitis (AFR) is a specific condition requiring differentiation from other chronic rhinosinusitis forms for appropriate management.
- Fungi are implicated in conditions such as allergic rhinitis, bronchial asthma, allergic bronchopulmonary aspergillosis, and hypersensitivity pneumonitis.
Purpose:
- To highlight the importance of distinguishing allergic fungal rhinosinusitis (AFR) from other chronic rhinosinusitis types due to treatment implications.
- To outline diagnostic approaches for fungal-induced allergic conditions.
- To summarize treatment modalities for allergic reactions to fungi.
Summary:
- Allergic reactions to fungi manifest in various organs, including airways, skin, and eyes, with nasal symptoms resembling allergic rhinitis.
- Diagnostic methods encompass standard allergological tests, mycologic cultures, direct microscopy, CT scans, and histopathology for conditions like AFR and allergic bronchopulmonary aspergillosis.
- Treatment strategies involve allergen avoidance, pharmacotherapy, antifungal agents, surgical intervention for AFR, and immunotherapy for specific fungal sensitivities.
Impact:
- Accurate diagnosis of fungal allergies facilitates targeted treatment, improving patient outcomes.
- Understanding the spectrum of fungal-induced allergic diseases aids in comprehensive patient care.
- Immunotherapy presents a valuable treatment option for patients sensitized to common fungi like Cladosporium and Alternaria.