A Closer Look At Allergic Fungal Sinusitis

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 allergy.

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.

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