title: Fungal disease of the nose and sinuses: an updated overview.
abstract: Fungal diseases of the nose and sinuses encompasses a diverse spectrum of disease. Clinical manifestations are largely dependent upon the immune status of the host, as, given the ubiquitous nature of these organisms, exposure is unavoidable. Asymptomatic colonization of the nasal passages by fungi warrants no treatment and is common, while allergic fungal rhinosinusitis is challenging and often requires a combined approach of surgical intervention, immunotherapy, and corticosteroid administration. A diagnosis requires a combination of IgE immune reactivity, eosinophilic infiltration, and fungi recovery. Similarly, invasive disease may present only after several months of slowly progressive disease, or in rapid and fulminant fashion in the appropriate host. A differentiation of these overlapping syndromes and the pathophysiologic processes at play, and recommended treatment algorithms, are the focus of this review.
authors.affiliation: Department of Pediatrics, Division of Allergy, Asthma, and Immunology, Nemours/A.I. Dupont Hospital for Children, Thomas Jefferson University, 1600 Rockland Road, Wilmington, DE, 19803, USA. cchang@nemours.org
authors.forename: Christopher
authors.initials: C
authors.lastname: Chang
authors.forename: M Eric
authors.initials: ME
authors.lastname: Gershwin
authors.forename: George R
authors.initials: GR
authors.lastname: Thompson
mesh_terms: D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D009181:Mycoses / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D059747:Nasal Surgical Procedures; D009668:Nose Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy
chemical_list: D005938:Glucocorticoids