ALLERGIC FUNGAL SINUSITIS - THE MAYO-CLINIC EXPERIENCE

The diagnosis of allergic fungal sinusitis (AFS) is difficult to estab lish. The clinical presentation is not diagnostic. We define current c riteria for diagnosis and the role of total and specific immunoglobuli n E (IgE) and immunoglobulin G (IgG) levels in the disease process and review the clinical features of this disease. Fifty-one cases were id entified in 44 patients who demonstrated characteristic allergic mucin . Thirty-one of these cases satisfied rigid criteria for the diagnosis of AFS. Twenty of these cases were classified as AFS-like syndrome. T he prevalence of strictly defined AFS was 4.0%. Dematiaceous fungi wer e the predominant agents cultured. All our patients had polyps, 23 (54 %) had asthma, 12 (27%) had aspirin sensitivity, 20 (65%) had eosinoph ilia, and 9 (69%) had increased total IgE levels.