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Sinus aspergillosis and allergic fungal sinusitis.

R W Hartwick1, J G Batsakis

  • 1Dept of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.

The Annals of Otology, Rhinology, and Laryngology
|May 1, 1991
PubMed
Summary

This study outlines four types of sinonasal aspergillosis, differentiating between saprophytic and infectious forms. Surgical removal is key for treating all fungal sinusitis types, often with antifungal medications and steroids.

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Area of Science:

  • Otolaryngology
  • Mycology
  • Infectious Diseases

Background:

  • Sinonasal aspergillosis presents in four clinicopathologic forms based on fungal involvement (mucosal vs. extramucosal).
  • These forms include saprophytic (aspergilloma, allergic Aspergillus sinusitis) and infectious (chronic indolent, invasive fulminant sinusitis) types.
  • Invasive fungal sinusitis can be rapidly fatal, especially in immunocompromised individuals.

Purpose of the Study:

  • To categorize the clinicopathologic presentations of sinonasal aspergillosis.
  • To highlight the role of fungal antigens in allergic forms.
  • To emphasize diagnostic confirmation and therapeutic strategies.

Main Methods:

  • Review of clinicopathologic presentations of sinonasal aspergillosis.

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  • Discussion of diagnostic considerations, including culture confirmation for fungal agents.
  • Outline of therapeutic mainstays and adjunctive treatments.

    • Main Results:

    • Four distinct clinicopathologic presentations of sinonasal aspergillosis are identified.
    • Allergic fungal sinusitis is linked to hypersensitivity to fungal antigens, requiring specific fungal identification.
    • Tissue-invasive and angioinvasive forms pose significant mortality risks.

    Conclusions:

    • Surgical extirpation of the fungus is the primary treatment for all sinonasal fungal sinusitis.
    • Antifungal agents and corticosteroids serve as crucial adjuncts to surgical management.
    • Accurate diagnosis, including fungal species identification, is essential for effective treatment of sinonasal aspergillosis.