Clinical, Radiological, and Histopathological Patterns of Allergic Fungal Sinusitis: A Single-Center Retrospective Study

ObjectivesTo explore the clinical, pathological, and imaging characteristics of allergic fungal sinusitis (AFS) and to analyze the correlation of disease duration with imaging and histopathology findings.MethodsWe reviewed all cases of AFS managed at the otorhinolaryngology department of King Fahad...

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Published in:Curēus (Palo Alto, CA) CA), 2020-07, Vol.12 (7), p.e9233-e9233
Main Authors: Salamah, Marzouqi A, Alsarraj, Mazin, Alsolami, Nawaf, Hanbazazah, Kamal, Alharbi, Abdulmajeed M, Khalifah, Wael
Format: Article
Language:English
Subjects:
Age
Antibiotics
Asthma
Diabetes
Evolution
Fungal infections
Gender
Histopathology
Hypertension
Laboratories
Olfaction disorders
Otolaryngology
Pathology
Sinuses
Sinusitis
Standard deviation
Surgery
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Summary:ObjectivesTo explore the clinical, pathological, and imaging characteristics of allergic fungal sinusitis (AFS) and to analyze the correlation of disease duration with imaging and histopathology findings.MethodsWe reviewed all cases of AFS managed at the otorhinolaryngology department of King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Demographic and clinical features were collected, as well as imaging and histopathological findings, which were analyzed by time from onset.ResultsForty-six patients were diagnosed AFS, representing 11.8% of total sinusitis cases; 25 (54.3%) were female, with mean (SD) age=33.57 (11.76). Patients presented with multiple symptoms of chronic rhinosinusitis (43, 93.5%), chronic headache (14, 30.4%), and hyposmia (2, 4.3%), and 36 (78.3%) were diagnosed late (≥5 years after onset). AFS involved all four sinuses in 32 (69.6%) patients and was bilateral in >53.5% of infected sinuses. Imaging showed increased intrasinus attenuation (88.2%-95.3%), complete opacification (74.4%-85.3%), sinus expansion (35.3%-51.2%), remodeling (20.6%-37.2%), wall thinning (41.2%-58.1%), and involvement of adjacent soft tissue (11.8%-25.6%), depending on the sinus type. Histology evidenced eosinophilic mucin (45.7%), eosinophils (91.3%), fungal hyphae (93.5%), and Charcot-Leyden crystals (6.5%). Patients who were diagnosed late had a higher percentage of imaging and pathological lesions, principally, the expansion and wall thinning of involved sinuses (p
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.9233