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Allergic fungal sinusitis presenting with proptosis and diplopia: A review of ophthalmologic complications and treatment

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Allergic fungal sinusitis is a noninvasive, but vigorous, inflammatory response to mold that occurs in immunocompetent patients with chronic sinusitis and nasal polyposis. It typically occurs in patients who have a history of atopic disease. Occasionally, the patients with allergic fungal sinusitis present with ophthalmic signs and symptoms—most commonly proptosis and diplopia. We report the case of a 23-year-old man with right-sided proptosis, diplopia, and nasal obstruction. He had a history of sinusitis in the past. On presentation, sinus computed tomography scan showed pansinusitis. Subsequent workup revealed elevated immunoglobulin E and positive skin testing to several molds including Bipolaris spicifera and Aspergillus fumigatus. Functional endoscopic sinus surgery was performed, and the surgical specimen revealed allergic mucin with eosinophils, Charcot–Leyden crystals, and a silver stain showing fungal elements. His symptoms, including proptosis and diplopia, improved after surgical debulking and use of systemic corticosteroids.
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Document Type: Research Article

Publication date: 01 January 2006

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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