Early Treatment of Allergic Fungal Sinusitis
In the beginning, allergic fungal sinusitis was originally mistaken
for a paranasal sinus tumor. It has since been recognized to
be an allergic reaction to fungi, usually fungi of the dematiaceous
species. Now, most medical professionals understand allergic
fungal sinusitis to be an allergic reaction to fungi in which
fungal buildup, allergic mucin, and nasal polyposis occur in
the nasal cavity and paranasal sinuses.
Fungal disease in the nasal cavities and paranasal sinuses was
originally considered an invasive deadly disease. Treatment relied
on surgery followed by systemic and topical antifungal treatments.
Due to limited culture techniques and lack of research about the
cause of allergic fungal sinusitis, Aspergillus used to be the
only fungus recovered from the paranasal sinuses of patients with
allergic fungal sinusitis. Aspergillus is a fungus known to cause
invasive disease in the sinuses, and thus, patients with allergic
fungal sinusitis were forced to undergo rather aggressive treatments
for the disease. Doctors did not originally have enough knowledge
about dematiaceous fungi and its potential to cause disease in
the paranasal sinuses, and thus treatment was not always accurate.
Due to advancements in technology and the understanding of sinus
cultures, allergic fungal sinusitis was more accepted as a benign
fungal process by the late 1980s. It was then understood that allergic
fungal sinusitis was often confused with a paranasal sinus tumor
during examination and imaging because allergic fungal sinusitis
creates expansion of the sinus cavities affected by the fungal
Patients With Allergic Fungal Sinusitis
It has been uncovered that most patients with allergic fungal sinusitis
have a history of allergic rhinitis (some also suffer from asthma)
and, because of this, the exact timing of allergic fungal sinusitis
development can be difficult to determine. A patient may believe
that what they are experiencing is allergic rhinitis, when, in
reality, it may be allergic fungal sinusitis. It has also been
reported that 5 to 10 percent of patients suffering from chronic
sinusitis are actually being affected by allergic fungal sinusitis.
Mayo clinic researchers believe it may be a much higher percentage.
During allergic fungal sinusitis, thick fungal accumulation and
mucin are developed in the sinus cavities. This fungus and mucin
must be removed surgically in order for the allergen causing the
reaction to no longer be present. Antibiotics are ineffective against
allergic fungal sinusitis as it is a fungus that triggers an allergic
reaction, however, antifungal agents have been effective against
the disease in past patients. Even though it is an allergic reaction,
antihistamines do not relieve or reverse the symptoms of patience
with allergic fungal sinusitis. A person who has suffered from
allergic fungal sinusitis may experience a recurrence of the disease,
even after surgery but anti-inflammatory medical therapy and immunotherapy
are being employed to help prevent recurrence.