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Health care information for sinusitis sufferers |  |
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Health care information for sinusitis sufferers | |
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Inflammatory & Infectious Causes
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CausesInflammatory & Infectious CausesAllergies | Bacterial | Fungus | Polyps | Reflux | Viral |Fungus Allergic Fungal Sinusitis (AFS) AFS is a noninvasive disease (meaning fungus does not invade the tissues) that accounts for approximately 7% of all chronic sinusitis requiring surgical intervention. It can occur at any age, but is most common in adolescents and young adults. Sufferers typically have competent immune systems, but a strong history of allergy. Almost all have nasal polyps. About 40% also have asthma. A person suffering from AFS will nearly always develop chronic sinusitis, with persistent symptoms of nasal obstruction and loss of smell. Eventually, the condition can lead to proptosis, or displacement of the eyeball – or even erosion of tissue inside the skull and vision loss. Diagnosis of AFS Diagnosis of AFS is based on the presence of characteristic findings when a mucus sample is examined under the microscope. To the naked eye, the mucus plugs are rubbery, green-gray, or tan. Lab technicians look for special blood cells called eosinophils as well as stringy filaments, or hyphae, which are a telltale sign of fungus. Special fungal staining of the specimen may help technicians detect the fungus. There is no increased aspirin sensitivity among patients with allergic fungal sinusitis – as there is in the case of some patients with asthma and nasal polyps. Therapies for AFS The current therapy for AFS involves surgical removal of all allergic mucin from the affected sinuses. This can usually be accomplished under endoscopic surgical guidance and is facilitated with the use of a microdebrider. Steroids are usually begun at the time of surgery and continued for several weeks until the sinuses are healed. Afterwards, most patients will experience improvement in nasal congestion, drainage, headache, and other associated symptoms. Unfortunately, relief is almost always temporary, and the polyps and associated AFS symptoms frequently recur. Steroids by mouth can treat recurrent cases of AFS; however, long-term use has side effects such as osteoporosis, so alternative therapies are often explored. The newest hopes for AFS sufferers include immunotherapy, a series of injections to desensitize patients to the fungus that is triggering their illness, and systemic antifungal agents that treat the entire body with the hope of eliminating fungal colonies. A related condition, Allergic Bronchopulmonary Aspergillosis (ABPA), which affects the lungs instead of the nose and sinuses, is commonly treated using steroids by mouth. Back to Fungus page
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