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Allergic aspergillus sinusitis--an overlooked diagnosis?

D Jonathan1, V Lund, C Milroy

  • 1Royal National Throat, Nose and Ear Hospital, London.

Insights

Allergic aspergillus sinusitis is a recently recognized non-invasive fungal infection causing chronic sinusitis. Diagnosis can be challenging due to scanty fungal elements, requiring specific stains for identification.

Area of Science:

  • Mycology
  • Otolaryngology
  • Allergy Immunology

Background:

  • Nasal and sinus Aspergillus infections have been known for a century.
  • A distinct non-invasive variant, allergic aspergillus sinusitis, has recently emerged.
  • This condition presents as chronic sinusitis with unique pathological findings.

Observation:

  • Characterized by the presence of thick, green, inspissated mucus.
  • Microscopic examination reveals eosinophils and Charcot-Leyden crystals.
  • Fungal hyphae are often scanty and require special stains for detection.

Findings:

  • Allergic aspergillus sinusitis is a non-invasive form of fungal sinusitis.
  • Diagnosis is frequently overlooked due to low fungal burden and need for special stains.
  • Shares similarities with allergic bronchopulmonary aspergillosis.

Implications:

  • Early and accurate diagnosis is crucial for effective management.
  • Treatment involves surgical debridement and aeration.
  • Corticosteroids, topical or systemic, may be used adjunctively.

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