title: Presentation and management of allergic fungal sinusitis.
abstract: OBJECTIVE
  To assess the presentation of allergic fungal sinusitis and describe the line of management in our setup.
  
  
  METHODS
  Descriptive study.
  
  
  METHODS
  Study was conducted in Otorhinolaryngology Department, Dow Medical College and Civil Hospital, Karachi, from January 2004 to January 2005.
  
  
  METHODS
  Culture and sensitivity / fungal stain proven 20 cases of allergic fungal sinusitis were selected for the study, irrespective of age and gender. Data including age, gender, socioeconomic status, signs, symptoms, laboratory findings (especially Immunoglobulin E and eosinophil count) and imaging studies (Computed Tomography and /or Magnetic Resonance Imaging) were noted for the study. Pre and postoperative medical treatment, surgery performed, follow-up; residual/recurrence disease and revised surgery performed were also recorded.
  
  
  RESULTS
  In this series, allergic fungal sinusitis was a disease of younger age group with an average age of 20.75 years with male dominance (70%). Poor socioeconomic status (80%), allergic rhinitis (100%) and nasal polyposis (100%) were important associated factors. Nasal obstruction (100%), nasal discharge (90%), postnasal drip (90%) and unilateral nasal and paranasal sinuses involvement (60%) were the commonest presenting features. Aspergillus (60%) was the most common etiological agent. In all cases (100%), increased eosinophil count and IgE levels were present. Orbital (20%) and intracranial (10%) involvement were also seen. Surgical management was preferred in all cases. Functional endoscopic sinus surgery in 90% cases and lateral rhinotomy in 10% cases were performed. Recurrence / residual disease was seen in 20% cases.
  
  
  CONCLUSIONS
  In this series, allergic fungal sinusitis was seen in immunocompetent, young males, belonging to poor socioeconomic status, suffering from allergic rhinitis and nasal polyposis, presenting with nasal obstruction, nasal discharge and postnasal drip. Functional endoscopic sinus surgery was the most important problem solving procedure while lateral rhinotomy was reserved for extensive disease.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital, Karachi.
authors.forename: Kalimullah
authors.initials: K
authors.lastname: Thahim
authors.forename: Mahboob Afzal
authors.initials: MA
authors.lastname: Jawaid
authors.forename: M Saleem
authors.initials: MS
authors.lastname: Marfani
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D012852:Sinusitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology / Q000628:therapy*; D012923:Social Class; D014057:Tomography, X-Ray Computed