title: Understanding paediatric allergic fungal sinusitis: Is it more aggressive?
abstract: OBJECTIVE
  To study and characterize the features of AFRS in children as compared to adults.
  
  
  METHODS
  50 consecutive patients of AFRS attending our outpatient department were included in the study from July 2011 to December 2013. They were divided into two groups (A and B) according to age being ≤14 years and >14 years. Clinical history and examination included anterior rhinoscopy, SNOT 20 scores, CT of Nose and PNS (para nasal sinuses) (Lund Mackay scores), diagnostic nasal endoscopy (Kupferberg's grades), punch biopsy from nasal polyp, serum IgE, absolute eosinophil counts (AEC) and Aspergillus skin hypersensitivity test was done in all patients for conformation of AFRS. Bent and Kuhn's criteria were used for diagnosis. Sweat chloride levels were done in all patients of group A.
  
  
  RESULTS
  Group A had 12 patients and group B had 38. Mean duration of symptoms was significantly less in children as compared to adults (p<0.05). All patients of both groups had nasal polyposis at presentation. Unilateral disease and multisinus involvement was more common in children (6/12) as compared to adults. Proptosis (2/12) and telecanthus (4/12) was more common in children (group A) as compared to adults (group B). LM (Lund Mackay) scores and serum IgE were significantly high in children as compared to adults. Follow up CT scans showed early evidence of recurrence in children as compared to adults (p<0.05).
  
  
  CONCLUSIONS
  AFRS was seen to be more aggressive in children with increased fungal load when compared with adults. Typically, AFRS in children was less responsive to treatment with increased recurrence rates.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Sourabha K
authors.initials: SK
authors.lastname: Patro
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Electronic address: roshanverma@hotmail.com.
authors.forename: Roshan K
authors.initials: RK
authors.lastname: Verma
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Naresh K
authors.initials: NK
authors.lastname: Panda
authors.affiliation: Department of Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Arunaloke
authors.initials: A
authors.lastname: Chakrabarti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000382:microbiology; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology; D012882:Skin Tests; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Aggressive; Allergic fungal rhinosinusitis; Paediatric; Recurrence