Treatment of allergic fungal sinusitis: A comparison trial of postoperative immunotherapy with specific fungal antigens

1998 ◽  
Vol 108 (11) ◽  
pp. 1623-1627 ◽  
Author(s):  
Randy J. Folker ◽  
Bradley F. Marple ◽  
Richard L. Mabry ◽  
Cynthia S. Mabry
Keyword(s):  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Comparison Trial ◽  
Fungal Antigens

scholarly journals Visual loss in the setting of allergic fungal sinusitis: pathophysiology and outcome

2007 ◽  
Vol 121 (11) ◽  
pp. 1055-1059 ◽  
Author(s):  
A K Gupta ◽  
S Bansal ◽  
A Gupta ◽  
N Mathur
Keyword(s):  
Visual Loss ◽  
Case Series ◽  
Lateral Wall ◽  
Contralateral Side ◽  
Pathophysiological Mechanism ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Laboratory Findings ◽  
Fungal Antigens ◽  
Fungal Serology

AbstractObjective:To hypothesise the probable pathophysiological mechanism responsible for visual loss in allergic fungal sinusitis, other than direct compression.Design:Retrospective, non-randomised case series. Out of 274 cases of allergic fungal sinusitis, four cases with sudden visual loss were enrolled into the study. The fourth case had visual loss on the contralateral side to bony erosion of the lateral wall of the sphenoid sinus.Interventions:All four cases were evaluated with fungal smear, immunoglobulin (Ig) E titres, visual evoked potentials, non-contrast computed tomography and magnetic resonance imaging of the paranasal sinuses, and fundus examination. They then underwent endoscopic sinus debridement followed by intravenous methylprednisolone.Outcome measures:Improvement in vision.Results:All four cases experienced an improvement in vision: full recovery in three cases and partial improvement in one case.Conclusion:In view of the operative, radiological and laboratory findings for case four, with the suggestion of a hyperimmune response to fungal antigens (in the form of raised IgE titre and positive fungal serology), we suggest that a local immunological reaction to fungal antigens might be responsible for the observed visual loss in cases of allergic fungal sinusitis, in addition to mechanical compression of the optic nerve.

Comprehensive Management of Allergic Fungal Sinusitis

1998 ◽  
Vol 12 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Bradley F. Marple ◽  
Richard L. Mabry
Keyword(s):  
Preoperative Evaluation ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Radiographic Findings ◽  
Comprehensive Management ◽  
Medical Preparation ◽  
Systemic Corticosteroids ◽  
Allergic Mucin ◽  
Fungal Antigens

In little more than a decade, allergic fungal sinusitis has gone from a medical curiosity to one of the more perplexing problems to challenge the otorhinolaryngologist. These patients are typically immunocompetent adolescents or young adults with pansinusitis (unilateral and bilateral) and polyposis, atopy, and characteristic radiographic findings. Allergic mucin contained within the sinuses demonstrates numerous eosinophils and Charcot-Leyden crystals, and fungal stains show the presence of noninvasive hyphae. Fungal cultures may or may not be positive. We have found the following approach to allergic fungal sinusitis to be most effective: 1) Adequate preoperative evaluation and medical preparation; 2) Meticulous exenterative surgery; 3) Closely supervised immunotherapy with relevant fungal and non-fungal antigens; 4) Medical management including topical and systemic corticosteroids as needed; 5) Irrigation and self-cleansing by the patient; and 6) Close clinical follow-up with endoscopically guided debridement when necessary.

scholarly journals Molecular Identification of Schizophyllum commune as a Cause of Allergic Fungal Sinusitis

2012 ◽  
Vol 32 (5) ◽  
pp. 375-779 ◽  
Author(s):  
Eun Jeong Won ◽  
Jong Hee Shin ◽  
Sang Chul Lim ◽  
Myung Geun Shin ◽  
Soon Pal Suh ◽  
...  
Keyword(s):  
Molecular Identification ◽  
Schizophyllum Commune ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

Mold testing by RAST and skin test methods in patients with allergic fungal sinusitis

1999 ◽  
Vol 121 (3) ◽  
pp. 252-254 ◽  
Author(s):  
Richard L. Mabry ◽  
Bradley F. Marple ◽  
Cynthia S. Mabry
Keyword(s):  
Skin Test ◽  
Test Methods ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

Ethnic and Gender Differences in Bone Erosion in Allergic Fungal Sinusitis

2004 ◽  
Vol 18 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Sarah K. Wise ◽  
Giridhar Venkatraman ◽  
Justin C. Wise ◽  
John M. DelGaudio
Keyword(s):  
Gender Differences ◽  
Bone Erosion ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
And Gender

Allergic Fungal Sinusitis

2010 ◽  
pp. 127-135
Author(s):  
Matthew W. Ryan ◽  
Bradley F. Marple
Keyword(s):  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

Demonstration of Biofilm in Human Bacterial Chronic Rhinosinusitis

2005 ◽  
Vol 19 (5) ◽  
pp. 452-457 ◽  
Author(s):  
Berrylin J. Ferguson ◽  
Donna B. Stolz
Keyword(s):  
Chronic Rhinosinusitis ◽  
Culture Media ◽  
Cellular Membrane ◽  
Anaerobic Growth ◽  
Bacterial Biofilms ◽  
Topical Steroids ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Planktonic Bacteria ◽  
Transmission Electron

Background Bacterial biofilms may explain why some patients with bacterial chronic rhinosinusitis (CRS) improve while on antibiotics but relapse after completion of the antibiotic. In the human host, biofilms exist as a community of bacteria surrounded by a glycocalyx that is adherent to a foreign body or a mucosal surface with impaired host defense. Biofilms generate planktonic, nonadherent bacterial forms that may metastasize infection and generate systemic illness. These planktonic bacteria are susceptible to antibiotics, unlike the adherent biofilm. Methods We reviewed four cases of CRS using transmission electron microscopy (TEM) to assay for typical colony architecture of biofilms. Bacterial communities surrounded by a glycocalyx of inert cellular membrane materials consistent with a biofilm were shown in two patients. Results In the two patients without biofilm, a nonbacterial etiology was discovered (allergic fungal sinusitis) in one and in the other there was scant anaerobic growth on culture and the Gram stain was negative. Culture of the material from the biofilm grew Pseudomonas aeruginosa in both patients. Pseudomonas from the biofilm showed a glycocalyx, not present in Pseudomonas cultured for 72 hours on culture media. Both patients’ symptoms with bacterial biofilms were refractory to culture-directed antibiotics, topical steroids, and nasal lavages. Surgery resulted in cure or significant improvement. Conclusion Biofilms are refractory to antibiotics and often only cured by mechanical debridement. We believe this is the first TEM documentation of bacterial biofilms in CRS in humans.

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