title: Complications of allergic fungal sinusitis.
abstract: OBJECTIVE
  Allergic fungal sinusitis is a syndrome of chronic noninvasive fungal sinusitis that results in the accumulation of eosinophil-rich allergic mucin within the paranasal sinuses. This mucin may become an expansile mass leading to complications that have not been well characterized or classified.
  
  
  METHODS
  Inclusion criteria for this study required meeting previously published diagnostic criteria and complications greater than nasal polyps or sinusitis itself. Four patients from our cohort and 30 patients identified in a literature search formed the study group.
  
  
  RESULTS
  The majority of patients had pre-existing asthma or allergic rhinitis, or both, and 37% had nasal polyps before presentation. However, 27% had no previous history of rhinosinusitis or nasal polyposis. Complications of allergic fungal sinusitis fell into discrete categories: ophthalmic (n=13), sinobronchial allergic mycosis (n=9), bony erosion (n=8), cavernous venous thrombosis (n=3), and otic involvement (n=1).
  
  
  CONCLUSIONS
  Visual symptoms, proptosis, headaches, and increased nasal symptoms, especially in association with bony erosions on sinus computed tomography, suggest allergic fungal sinusitis and its complications in patients with chronic rhinosinusitis and nasal polyps. Patients with allergic fungal sinusitis may present with a complication of the disease as the first symptom. Complications may be categorized into groups that facilitate surveillance and early identification.
authors: Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors: Sarah
authors: S
authors: Bozeman
authors: Richard
authors: R
authors: deShazo
authors: Scott
authors: S
authors: Stringer
authors: Leigh
authors: L
authors: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology*; D010256:Paranasal Sinuses / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D012852:Sinusitis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D011241:Prednisone