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Allergic aspergillus sinusitis--an overlooked diagnosis?
1Royal National Throat, Nose and Ear Hospital, London.
The Journal of Laryngology and Otology
|December 1, 1989
Summary
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.