Preoperative Diagnosis of Allergic Fungal Sinusitis

Dhiwakar, Muthuswamy; Thakar, Alok; Bahadur, Sudhir; Sarkar, Chitra; Banerji, Uma; Handa, Kumud Kumar; Chhabra, Sanjeev

doi:10.1097/00005537-200304000-00020

Cited by 47 publications

(46 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

“…Although A. fumigatus seems to be the most frequent Aspergillus organism causing AFS, A. flavus is particularly frequent in some geographical areas, such as the Middle East and India (Taj-Aldeen et al, 2003, 2004Saravanan et al, 2006;Thakar et al, 2004). Patients with AFS may have co-existent mucosal granulomatous inflammation indicative of fungal tissue invasion (Thakar et al, 2004).…”

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

“…Patients with AFS may have co-existent mucosal granulomatous inflammation indicative of fungal tissue invasion (Thakar et al, 2004). In these cases from India, A. flavus was the only pathogen identified (Thakar et al, 2004). Sinus aspergilloma (fungus ball) is also usually caused by A. fumigatus and such infections caused by A. flavus are less frequent in developed countries (Milosev et al, 1969;Stammberger et al, 1984;Ferreiro et al, 1997).…”

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

See 2 more Smart Citations

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

et al. 2007

View full text Add to dashboard Cite

Aspergillus infections have grown in importance in the last years. However, most of the studies have focused on Aspergillus fumigatus, the most prevalent species in the genus. In certain locales and hospitals, Aspergillus flavus is more common in air than A. fumigatus, for unclear reasons. After A. fumigatus, A. flavus is the second leading cause of invasive aspergillosis and it is the most common cause of superficial infection. Experimental invasive infections in mice show A. flavus to be 100-fold more virulent than A. fumigatus in terms of inoculum required. Particularly common clinical syndromes associated with A. flavus include chronic granulomatous sinusitis, keratitis, cutaneous aspergillosis, wound infections and osteomyelitis following trauma and inoculation. Outbreaks associated with A. flavus appear to be associated with single or closely related strains, in contrast to those associated with A. fumigatus. In addition, A. flavus produces aflatoxins, the most toxic and potent hepatocarcinogenic natural compounds ever characterized. Accurate species identification within Aspergillus flavus complex remains difficult due to overlapping morphological and biochemical characteristics, and much taxonomic and population genetics work is necessary to better understand the species and related species. The flavus complex currently includes 23 species or varieties, including two sexual species, Petromyces alliaceus and P. albertensis. The genome of the highly related Aspergillus oryzae is completed and available; that of A. flavus in the final stages of annotation. Our understanding of A. flavus lags far behind that of A. fumigatus. Studies of the genomics, taxonomy, population genetics, pathogenicity, allergenicity and antifungal susceptibility of A. flavus are all required.

show abstract

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

Section: Allergic Fungal Sinusitis (Afs) and Sinus Aspergillomamentioning

confidence: 99%

See 1 more Smart Citation

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Preoperative diagnosis will guide the surgeon on the surgical approach, extent of surgery and adjuvant medical therapy [21]. Although allergic fungal sinusitis usually follows a slow non-aggressive course, the disease can extend outside the confines of the sinuses with the possibility of massive bone destruction [22].…”

Section: Discussionmentioning

confidence: 99%

Allergic Fungal Rhinosinusitis in the Lesser and Greater Wings of the Sphenoid With Resultant Optic Neuropathy: A Case Report and Review of the Literature

Chaaban

2012

J Curr Surg

View full text Add to dashboard Cite

The anatomy of the paranasal sinuses is important to be considered during clinical evaluation particularly for preoperative surgical planning. We report on a patient with allergic fungal sinusitis that presented with visual loss secondary to compressive optic neuropathy as a result of a rare anatomical variant of hyper-aerated lesser and greater wing of the sphenoid. This variant alone would not have come to medical attention were it not for the concomitant allergic fungal sinusitis causing expansion of the sinus cavities with resultant visual loss.

show abstract

“…Dhiwakar et al suggest that the combination of nasal polyposis, CT scan with heterogeneity and bone erosion, and specific elevated fungal IgE titer have high preoperative predictive value for AFS [36] . Most authors report nasal polyps in all forms of eosinophilic sinus disease, and therefore it may be sensitive but not specific for the diagnosis of AFS.…”

Section: Clinical Presentationmentioning

confidence: 99%

Allergic Fungal Sinusitis: Controversy and Evolution of Understanding with Therapeutic Implications

Ferguson

Mehta

2009

Allergy Frontiers: Therapy and Prevention

View full text Add to dashboard Cite

Fungal rhinosinusitis can be categorized into distinct forms on the basis of histopathology. The invasive manifestations are fulminant or rapidly progressing, chronic or indolent, and granulomatous. The noninvasive manifestations are fungus balls and allergic fungal sinusitis (AFS). A noninvasive and controversial category introduced within the last decade resembles AFS; however, patients are not allergic and are termed nonallergic eosinophilic fungal rhinosinusitis (NA-EFRS). AFS or NA-EFRS is the subject of this chapter and will be contrasted to eosinophilic sinus disease in which fungi are absent.Classically, AFS is defined as the histopathologic presence of eosinophilic mucin containing fungal hyphae retrieved from the nose or paranasal sinuses from patients who demonstrate IgE mediated allergy to the fungus. Patients with AFS often have asthma, peripheral eosinophilia, nasal polyps, and allergic rhinitis. The nose and sinus contents contain green, sticky or tan mucin plugs, which when examined pathologically reveal eosinophilic mucin, Charcot Leyden crystals, degenerating inflammatory cells, and sparse hyphae (Fig. 1 ).The presence of hyphae is considered to be important in making the diagnosis; however, hyphal presence is often sparse and the diagnosis of AFS may be missed due to sampling error [1] . The absence of fungus histopathologically or of allergy has lead to two additional categorizations: (1) Nonfungal eosinophilic mucin rhinosinusitis (NF-EMRS) in which fungi are not seen or cultured and are NOT considered to be of etiologic importance [2] (Fig. 2 ) and (2) Nonallergic eosinophilic fungal rhinosinusitis (NA-EFRS) in which fungi are present and believed to be causal in the pathophysiology through nonallergic mechanisms [3] .

show abstract

Preoperative Diagnosis of Allergic Fungal Sinusitis

Cited by 47 publications

References 28 publications

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

Allergic Fungal Rhinosinusitis in the Lesser and Greater Wings of the Sphenoid With Resultant Optic Neuropathy: A Case Report and Review of the Literature

Allergic Fungal Sinusitis: Controversy and Evolution of Understanding with Therapeutic Implications

Contact Info

Product

Resources

About