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Allergic fungal sinusitis in children
Jenny M Campbell1, Melissa Graham, Heather C Gray
1Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas, USA.
Summary
Allergic fungal sinusitis (AFS) in children often presents with severe symptoms like nasal polyps and headaches. Early diagnosis and aggressive treatment, including surgery and immunotherapy, are crucial for managing this condition.
Area of Science:
- Otolaryngology
- Pediatric Allergy
- Rhinosinusitis Research
Background:
- Allergic fungal sinusitis (AFS) is recognized in adults with chronic sinusitis.
- Reports of AFS in children are infrequent, necessitating further characterization.
Purpose of the Study:
- To define the clinical features of AFS in pediatric patients.
- To establish diagnostic and treatment parameters for pediatric AFS.
Main Methods:
- Retrospective analysis of 20 children (ages 7-18) diagnosed with AFS over 12 years.
- Review of clinical presentation, laboratory results, imaging, pathology, and surgical outcomes.
- Inclusion criteria based on established AFS diagnostic standards.
Main Results:
- All pediatric patients exhibited atopy, nasal symptoms, and radiographic sinusitis.
- Common findings included nasal polyps (73%), recurrent headaches (60%), and asthma (55%).
- Proptosis (40%) and ocular symptoms (40%) were notable, with high rates of fungal allergy and elevated IgE/eosinophilia.
Conclusions:
- Pediatric AFS frequently presents with proptosis, more so than in adults.
- AFS in children typically affects atopic individuals with persistent sinus issues.
- A high index of suspicion and aggressive management are vital for effective AFS treatment in children.