Classification of fungal sinusitis in immunocompetent patients.
OBJECTIVE
The objective of this study was to review the subgroup classification of fungal sinusitis in immunocompetent patients.


METHODS
The study design included 19 immunocompetent patients with fungal sinusitis who were operated on between 1993 and 1998.


RESULTS
Ten of 19 patients showed a fungus ball. They underwent a limited surgical endoscopic procedure, and no further treatment was needed. Four patients had allergic fungal sinusitis and were treated postoperatively with irrigation, topical steroids, and oral steroids in 2 patients as well. Five patients had chronic sinusitis with significant bone erosion. All 5 underwent an extensive endoscopic procedure and were treated postoperatively by repeated irrigation, endoscopic cleaning, and no antifungal preparation. Two patients of this group are reported broadly.


CONCLUSIONS
Fungal sinusitis in immunocompetent patients is not a rare condition and can be divided into 3 categories: 1) fungus ball, 2) chronic erosive (noninvasive) fungal sinusitis, and 3) allergic fungal sinusitis. The symptomatology, treatment, and prognosis varied significantly among the 3 different categories.
Uri
Nechama
N
Otolaryngology-Head and Neck Surgery, Carmel Medical Center, 7 Michal St, Haifa 34362, Israel. druri@netvision.net.il
Cohen-Kerem
Raanan
R
Elmalah
Irit
I
Doweck
Illana
I
Greenberg
Elhanan
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology / Q000473:pathology; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed