Clinical presentation of allergic fungal sinusitis in Aden, Yemen

Abstract

Allergic fungal sinusitis, or eosinophilic fungal rhinosinusitis, is a barely recognized pathologic entity that
belongs to the fungal rhinosinusitis group. It is characterized by pathognomonic eosinophilic mucin-containing
hyphae besides other distinctive histological and imaging features that contribute to the diagnosis. The aim of the
study was to assess the presentation of allergic fungal sinusitis and to evaluate the different clinical features of this
clinical dilemma in Aden, Yemen. We performed a retrospective chart review of 64 patients with allergic fungal
sinusitis. They were (64.1%) males and (35.9%) females with ratio male to female 1.8:1. Their mean age was (25.9
± 9.02) years, range (10– 45) years. The most common symptoms was nasal obstruction 64 (100%) followed by nasal
discharges 35 (54.7%), headache 17 (26.6%), and anosmia 16 (25%). The difference between values of nasal
discharge is statistically significant (p < 0.05). Nasal polyps is the most common signs 64 (100%) followed by facial
disfigurement and ocular abnormalities (OA) 19 (29.7%). By CT-Scan examination, the nasal polyps were 49 (76.6%)
unilateral side and 15 (23.4%) bilateral side. Sinus expansion and double sign density found in all patients 64 (100%)
The difference between values of nasal discharge is statistically significant (p < 0.05). Total serum IgE ranged
between 500 IU/ml and 1200 IU/ml. The mean value of serum IgE of all patients was 704.9 ± 127.7 IU/ml and in
male patients was 682.6 ± 94.9 IU/ml while in female patients was higher 744.9±166.6 IU/ml. Polyps, nasal discharge,
facial disfigurement & ocular abnormalities, orbital extension, headache, anosmia and skull base erosion were the
most common presentations. Males are most commonly affected and most commonly affected age group is ≤20 to 30
years.