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Progressive Headaches and Right Eye Proptosis

  • Gordon Myers
  • Michael E. Dunham
  • Luke A. WallEmail author
Chapter

Practical Points

  • Allergic fungal rhinosinusitis is a distinct subtype of chronic rhinosinusitis with nasal polyposis

  • The diagnosis of allergic fungal rhinosinusitis has five major criteria: (1) type I hypersensitivity to fungus, (2) eosinophilic mucin in one or more sinus cavities without invasion, (3) characteristic CT scan findings, (4) nasal polyposis, and (5) positive fungal stain

  • Epidemiologically, the majority of patients with allergic fungal rhinosinusitis reside in the southeastern United States

  • Treatment options include a combination of endoscopic sinus surgery, systemic and topical glucocorticoids, and immunotherapy to fungal and non-fungal allergens. Preliminary studies support the use of omalizumab

Keywords

Allergic fungal rhinosinusitis Nasal polyposis Intranasal steroid Allergen immunotherapy 

References

  1. 1.
    Hamilos DL. Allergic fungal rhinitis and rhinosinusitis. Proc Am Thorac Soc. 2010;7(3):245–52.CrossRefGoogle Scholar
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    Glass D, Amedee RG. Allergic fungal rhinosinusitis: a review. Ochsner J. 2011;11(3):271–5.PubMedPubMedCentralGoogle Scholar
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    Peters AT, Spector S, Hsu J, Hamilos DL, Baroody FM, Chandra RK, Grammer LC, Kennedy DW, Cohen NA, Kaliner MA, Wald ER, Karagianis A, Slavin RG. Diagnosis and management of rhinosinusitis: a practice parameter update. Allergy Rhinol (Providence). 2014;113(4):347–85.Google Scholar
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    Evans MO 2nd, Coop CA. Novel treatment of allergic fungal sinusitis using omalizumab. Allergy Rhinol (Providence). 2014;5(3):172–4.CrossRefGoogle Scholar
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    Gan EC, Habib AR, Rajwani A, Javer AR. Omalizumab therapy for refractory allergic fungal rhinosinusitis patients with moderate or severe asthma. Am J Otolaryngol. 2015;36(5):672–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gordon Myers
    • 1
  • Michael E. Dunham
    • 2
  • Luke A. Wall
    • 1
    Email author
  1. 1.Section of Allergy Immunology, Department of Pediatrics, Children’s HospitalLouisiana State University School of MedicineNew OrleansUSA
  2. 2.Pediatric Otolaryngology, Children’s HospitalLouisiana State University School of MedicineNew OrleansUSA

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