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  Vol. 130 No. 9, September 2004 TABLE OF CONTENTS
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  •  Online Features
  Clinical Problem Solving: Radiology
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 •Infectious Diseases
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Radiology Quiz Case 4—Diagnosis

Arch Otolaryngol Head Neck Surg. 2004;130:1126-1127.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Allergic fungal sinusitis (AFS) of the right sphenoidal sinus

Allergic fungal sinusitis is generally recognized as a disease that is distinct from other forms of fungal sinusitis. It most commonly presents in adolescents and young adults, with approximately two thirds of patients reporting a history of allergic rhinitis, and half reporting a history of asthma. Clinical presentation varies from subtle nasal obstruction and crusting to extensive polyposis, chronic sinusitis, acute visual loss, proptosis, and facial dysmorphia. The pathogenesis of AFS is unclear, but immunologic and histologic data suggest that it represents an immunologically mediated disorder rather than an infectious entity. Cultures from patients with AFS most commonly yield organisms from the dematiaceous family of fungi, including Bipolaris. 1 Bent and Kuhn2 identified 5 common characteristics (ie, type I hypersensitivity, nasal polyposis, characteristic radiographic findings, eosinophilic mucin without invasion, and positive fungal stain) among 15 cases of AFS.

The differential diagnosis of fungal sinusitis is generally divided into invasive and noninvasive . . . [Full Text of this Article]


RELATED ARTICLE

Radiology Quiz Case 4
David L. Hicks, Elizabeth M. daCosta, and Donald B. Kearns
Arch Otolaryngol Head Neck Surg. 2004;130(9):1123.
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