Report of a successful prolonged antifungal therapy for refractory allergic fungal sinusitis

Allergic fungal sinusitis (AFS) is an increasingly recognized cause of refr actory chronic sinusitis in the young immunocompetent host, analogous to al lergic bronchopulmonary aspergillosis (ABPA), a related process in the lowe r respiratory tract. Most patients experience remittent disease despite cor ticosteroid therapy and aggressive sinus surgery. Because controlled trials have shown adjunctive antifungal therapy to be of benefit in treating ABPA , longterm oral itraconazole was used in a young man with remittent AFS, wh ich was able to break the cycle of relapsing disease.