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Letters to the Editor
December 2003

Shortfalls of Imaging Diagnostics for Allergic Fungal Sinusitis—Reply

Arch Otolaryngol Head Neck Surg. 2003;129(12):1351-1352. doi:10.1001/archotol.129.12.1351-a

In reply

Dr Öğretmenoğlu makes excellent points. Most patients do not have classic CT findings of bone erosion or extrasinus extension in the early course of invasive fungal sinusitis. Severe unilateral thickening of the nasal cavity mucosa is the most consistent finding on CT suggestive of underlying invasive fungal sinusitis in immunocompromised patients, but this is also a nonspecific finding and often represents other processes. The clinician cannot rely solely on CT imaging and must maintain a high index of suspicion when evaluating immunocompromised patients to establish a prompt diagnosis.1

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