Early and advanced allergic fungal rhinosinusitis

ABSTRACT

Allergic fungal sinusitis [AFS] has remained a diagnostic and therapeutic challenge. Early cases of allergic fungal sinusitis are rarely described prospective study in tertiary care facilities 26 patients diagnosed with AFS were treated by the author in the period from 2002 to 2005; most cases were from Jazan area in Saudi Arabia. Most cases were young women. Systemic corticosteroids, local corticosteroid and local amphotrecin B were used for all cases after surgery. Very high incidence of AFS in Jazan area. Patients with AFS have characteristic manifestation easily distinguishable from other rhino sinusitis and nasal polyposis patients. Ig E was consistently high in both early [750] and advanced [1550] cases, Ig E dropped significantly after treatment. CT scan findings were diagnostic except in very early cases. Erosion of the lamina paperacea was found in 5 cases. Erosion of the sphenoid sinus with intracranial extension was found in 2 cases. AFS is common in certain geographic areas and rare in other areas. All cases with nasal polyposis should be suspected to have AFS in areas with high incidence of the disease. Early cases of AFS are helpful for studying the natural history of this disease. Enviromental studies are needed to explore the pathogenesis of this disease