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Allergic Fungal Sinusitis

Patients with allergy to certain fungi may develop allergic fungal sinusitis. This occurs when the presence of fungus in the sinuses elicits a severe allergic response, resulting in production of allergic mucin (the main component in mucus) and nasal polyps. Usually, the disease affects more than one sinus on each side. However, in severe cases, all sinuses on both sides may be involved. AFS can be one of the most severe forms of sinusitis.

Treatment involves endoscopic sinus surgery to clear polyps and allergic mucin, and to restore the ventilation and drainage of the sinuses. Surgery must be combined with aggressive medical therapy with corticosteroids which can be used nasally. Patients may also benefit from treatment of their allergy through immunotherapy and antihistamines.

Anti-fungal treatment is usually not required, because it is the allergic reaction, and not the fungus itself, that is causing immediate symptoms. However, in severe cases of recurrent disease, anti-fungal therapy may be needed.