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October 1989

Allergic Fungal Sinusitis: Case Report and Review of the Mayo Clinic Experience

Author Affiliations

Oakland, Calif

Arch Otolaryngol Head Neck Surg. 1989;115(10):1159. doi:10.1001/archotol.1989.01860340013001

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At the recent 1989 Spring Meeting of the American Academy of Otolaryngic Allergy in San Francisco, Calif, Dr Jeffrey Bartynski, Mayo Clinic, Rochester, Minn, presented two cases of allergic fungal sinusitis. These patients had several findings in common, including significant allergic history, chronic rhinosinusitis failing medical therapy, and a slowly enlarging nasal mass causing proptosis. A computed tomographic scan showing "concretions" is characteristic of fungal sinusitis, but histopathologic identification of hyphae without deep invasion, eosinophils, and Charcot-Leyden crystals (allergic mucin) are necessary for the diagnosis. Treatment consisted of surgical débridement, postoperative steroid therapy, and allergic symptom control. Systematic antifungal regimens are not indicated. This disease must be differentiated from malignant processes as well as other fungal disorders, including mycetomas and invasive fungal sinusitis. Total IgE levels tend to parallel the course of the disease.

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