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September 1993

Allergic Aspergillus Sinusitis

Author Affiliations

Baltimore, Md
New York, NY

Arch Otolaryngol Head Neck Surg. 1993;119(9):1042-1043. doi:10.1001/archotol.1993.01880210136019

Allergic Aspergillus sinusitis seems to be diagnosed more frequently. This entity has definite similarities to allergic bronchopulmonary aspergillosis (ABPA) serologically and histopathologically. Rosenberg et al1 have suggested clinical and immunologic criteria for ABPA that includes: (1) bronchoconstriction, (2) eosinophilia, (3) immediate skin reactivity to Aspergillus antigen, (4) precipitin antibodies against Aspergillus antigen, (5) elevated IgE, (6) history of pulmonary infiltrates, and (7) central bronchiectasis. If all seven criteria are fulfilled, the diagnosis of ABPA is considered "definite." A "probable" diagnosis is made if six of seven criteria exist.

The clinical picture of allergic Aspergillus sinusitis and ABPA, however, is not strictly limited to Aspergillus species. Bipolaris,2Curvularia,3 and Exserohilum4 species have been cultured from individuals with sinusitis that is clinically and histopathologically indistinguishable from allergic Aspergillus sinusitis. Serologic evaluation is also similar in that total IgE is elevated, with demonstrable fungus-specific IgE and precipitin IgG antibod

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