Response of Visual Loss in Allergic Fungal Sinusitis to Oral Corticosteroids

2005 ◽  
Vol 114 (3) ◽  
pp. 247-249 ◽  
Author(s):  
Scott M. Graham ◽  
Keith D. Carter
Keyword(s):  
Visual Loss ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Medical Comorbidities ◽  
Oral Corticosteroids

Visual loss associated with allergic fungal sinusitis is most often treated with surgery followed by oral corticosteroids. A case is presented in which, because of substantial medical comorbidities, surgery could not be initially performed and the visual loss was corrected with prednisone alone. This case serves to reinforce the central role of corticosteroids in treatment of this enigmatic condition.

scholarly journals Role of Fungi in Allergic Fungal Sinusitis and Chronic Rhinosinusitis

2000 ◽  
Vol 75 (5) ◽  
pp. 540-541
Author(s):  
Jens U. Ponikau ◽  
David A. Sherris ◽  
Eugene B. Kern
Keyword(s):  
Chronic Rhinosinusitis ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

scholarly journals Optic nerve compression in allergic fungal sinusitis

2011 ◽  
Vol 125 (4) ◽  
pp. 381-385 ◽  
Author(s):  
A Thakar ◽  
P Lal ◽  
M Dhiwakar ◽  
S Bahadur
Keyword(s):  
Optic Nerve ◽  
Visual Loss ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Nerve Compression ◽  
Fungal Sinusitis ◽  
Tertiary Care Centre ◽  
Allergic Fungal Sinusitis ◽  
Urgent Surgery ◽  
Optic Nerve Compression

AbstractObjective:To describe the syndrome of optic nerve involvement in cases of allergic fungal sinusitis.Setting:Academic tertiary care centre.Methods:Analysis of prospectively accrued data for 10 consecutive cases (three bilateral, giving 13 eyes) with visual loss secondary to optic nerve compression, from a total of 70 cases of allergic fungal sinusitis undergoing surgical treatment between June 1997 and May 2007.Results:The mean duration of rhinological symptoms prior to the onset of visual loss was 22 months. At presentation, visual loss ranged from a visual acuity of 6/12 to complete loss of light perception. Bilateral involvement was noted in three of the 10 cases. Urgent surgical decompression with removal of all fungal debris and decompression of the optic nerve resulted in visual recovery in seven of the 13 eyes. On univariate analysis, recovery was less likely in cases with long standing visual loss, and in cases with complete visual loss.Conclusion:Long standing allergic fungal sinusitis may be complicated by visual loss due to compression of the optic nerve. Urgent surgery to clear the sinuses and decompress the optic nerve is successful in reversing visual loss in cases with partial visual loss.

scholarly journals Allergic fungal sinusitis presenting as visual loss and facial dysmorphia in New York City

2005 ◽  
Vol 115 (2) ◽  
pp. S198
Author(s):  
S. Kearney ◽  
M. Ellman ◽  
C. Wertenbaker ◽  
W. Mak ◽  
B. Silverman ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Visual Loss ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Facial Dysmorphia

Allergic Fungal Sinusitis-Induced Visual Loss

1999 ◽  
Vol 13 (3) ◽  
pp. 191-195 ◽  
Author(s):  
Bradley F. Marple ◽  
Scott R. Gibbs ◽  
Mark T. Newcomer ◽  
Richard L. Mabry
Keyword(s):  
Visual Loss ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis

Allergic Mucin With and Without Fungus

2001 ◽  
Vol 125 (11) ◽  
pp. 1442-1447
Author(s):  
Jonathan F. Lara ◽  
J. Daniel Gomez
Keyword(s):  
Tertiary Care ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Radiographic Findings ◽  
Care Institution ◽  
Tertiary Care Institution ◽  
Allergic Mucin ◽  
And Gender

Abstract Context.—Allergic mucin, a lamellated collection of inspissated inflammatory debris, has been a hallmark of allergic fungal sinusitis. While its identification is a clue for pathologists to search for fungi, and directs clinicians toward specific therapy and follow-up, recent reports describe cases with allergic mucin but without concomitant fungus. The absence of such organisms in otherwise typical allergic mucin brings into question the role of fungi in allergic fungal sinusitis. Objectives.—To study clinical and pathologic differences between patients with allergic mucin in surgical nasal resection specimens and to elucidate the role of fungus in allergic sinusitis. Design.—Patients with histologic evidence of allergic mucin, with and without fungus, were identified and retrieved from the surgical pathology files of a tertiary-care institution. The patients were separated into 2 groups for analysis, and their clinical and pathologic findings were reviewed and compared. Setting.—Tertiary-care institution. Patients.—All patients who underwent sinus mucosal resection between 1992 and 1998. Results.—Clinical presentation and radiographic findings were similar in both groups. Incidence, age, and gender distribution were similar to data reported previously. However, the amount of allergic mucin was much greater in the group with fungus than in the group without fungus, which to our knowledge is an unreported observation to date. Conclusion.—The presence of allergic mucin is not unique to allergic fungal sinusitis, but rather is the result of a process that could have other etiologies. While perhaps not always causative to the disease, the fungus continues to fuel the process and is likely an entrapped bystander. Allergic fungal sinusitis is more appropriately termed allergic mucinous sinusitis or eosinophilic mucinous rhinosinusitis.

Allergic Fungal Sinusitis Associated with Allergic Bronchopulmonary Aspergillosis: An Uncommon Sinobronchial Allergic Mycosis

2007 ◽  
Vol 21 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Jean Jacques Braun ◽  
Gabrielle Pauli ◽  
Philippe Schultz ◽  
André Gentine ◽  
David Ebbo ◽  
...  
Keyword(s):  
Allergic Bronchopulmonary Aspergillosis ◽  
Specific Ige ◽  
Antifungal Drugs ◽  
Sinus Surgery ◽  
Skin Tests ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Positive Skin ◽  
Oral Corticosteroids ◽  
Blood Eosinophils

Background The identification of allergic fungal sinusitis (AFS) is still controversial and much more recent than that of allergic bronchopulmonary aspergillosis (ABPA). Their association has been reported very rarely in the literature. Methods The aim of this study was to present a review of 6 cases of AFS associated with ABPA from a series of 12 cases of AFS and to compare AFS associated with ABPA and isolated AFS. Results All cases of AFS presented with chronic rhinosinusitis. The six cases with AFS and ABPA were atopic, asthmatic, with pulmonary infiltrates (five cases), central bronchiectasis (four cases), and both (three cases). The mycological and immunoallergological features of isolated AFS and AFS associated with ABPA were similar: eosinophilic allergic mucin with noninvasive fungi hyphae, high levels of blood eosinophils, total IgE, specific IgE, IgG, and positive skin tests to Aspergillus. The association of AFS and ABPA was concomitant (two cases) or remote in time (four cases). The treatment with oral corticosteroids and sinus surgery (six cases) associated with antifungal drugs (four cases) led to resolution in three cases, considerable improvement in one case, and therapeutic failure in two cases (follow-up longer than 5 years in all cases). Conclusion Independently of the signs linked to the organs involved (sinuses and bronchi) the mycological and immunoallergological features were similar for AFS and AFS associated with ABPA. AFS and ABPA can be isolated or associated in a sinobronchial allergic mycosis.

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.

scholarly journals The Role of CT Scan and Histopathology in Diagnosis of Allergic Fungal Sinusitis

2014 ◽  
Vol 7 (3) ◽  
pp. 117-120
Author(s):  
Bhanu Bhanu Bhardwaj ◽  
Jaskaran Singh Gill ◽  
Tanya Singh
Keyword(s):  
Ct Scan ◽  
Preoperative Diagnosis ◽  
Definitive Diagnosis ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Diagnostic Modality ◽  
Preoperative Diagnostic ◽  
A Prospective Study ◽  
Histological Verification

ABSTRACT Allergic fungal sinusitis is the disease with emerging incidence in last decade. The diagnosis of AFS requires a combination of clinical, radiographic, microbiological and histopathological information. CT scan findings in AFS are considered important in preoperative diagnosis but definitive diagnosis requires histological verification. The role of CT scan as the preoperative diagnostic modality in AFS has been analyzed in 50 patients in a prospective study conducted at our institute and results have been very assuring. This article will surely satisfy many inquisitive minds about the speculations regarding the diagnosis of AFS. How to cite this article Bhardwaj BB, Gill JS, Singh T. The Role of CT Scan and Histopathology in Diagnosis of Allergic Fungal Sinusitis. Clin Rhinol An Int J 2014;7(3):117-120.

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