| Allergic Aspergillus flavus rhinosinusitis: a case report from Qatar. | |
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MedLine Citation:
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PMID: 12883959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Fungal involvement in rhinosinusitis is classified into four major forms: allergic, mycetoma, chronic invasive (indolent) and acute invasive (fulminant). It can become life threatening if not diagnosed and treated properly. The preliminary diagnosis is usually made by nasal endoscopy and computed tomography (CT) imaging, but tissue biopsy and culture are of vital importance in confirming the disease and in planning treatment. We present a case of allergic fungal rhinosinusitis (AFS) caused by Aspergillus flavus. The clinical manifestation of the disease was the presence of an extensive left nasal polyp. An allergic workup revealed systemic eosinophilia (11.7%), high serum IgE levels (1,201 IU/ml) and a positive skin test for Aspergillus. CT scan showed a total opacification and expansion of the left nasal cavity and sinuses, with a secondary inflammatory reaction on the right side. There was no bony erosion beyond the sinus walls. The patient was operated on using an endoscopic approach (polypectomy and ethmoidectomy), where an abundant amount of allergic fungal mucin and dark crusts were found filling the sinuses. Fungal hyphae were evident in histopathological sections of the removed mucin. Culture of the debris resulted in the growth of Aspergillus flavus. The patient received a full course of systemic and topical steroids. The serum IgE level had dropped to 353 IU/ml and the peripheral eosinophil count to normal (1.38%) by the 10th postoperative month. Surgical debridement and corticosteroids may keep the disease quiescent for a long time. |
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Authors:
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Saad J Taj-Aldeen; Ali A Hilal; Agustin Chong-Lopez |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't Date: 2002-12-20 |
Journal Detail:
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Title: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery Volume: 260 ISSN: 0937-4477 ISO Abbreviation: Eur Arch Otorhinolaryngol Publication Date: 2003 Jul |
Date Detail:
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Created Date: 2003-07-28 Completed Date: 2003-12-16 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9002937 Medline TA: Eur Arch Otorhinolaryngol Country: Germany |
Other Details:
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Languages: eng Pagination: 331-5 Citation Subset: IM |
Affiliation:
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Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar. stajaldeen@hmc.org.qa |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aspergillosis / immunology*, microbiology Aspergillus flavus* / immunology Endoscopy Female Humans Qatar Rhinitis, Allergic, Perennial / diagnosis, immunology*, microbiology*, surgery Sinusitis / diagnosis, immunology*, microbiology*, surgery Tomography, X-Ray Computed |
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