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

Abstract

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.

• Authors: Christopher A Coop, Ronald W England
• Journal: Allergy and asthma proceedings (Allergy Asthma Proc) 2006 Jan-Feb Vol. 27 Issue 1 Pg. 72-6 ISSN: 1088-5412 [Print] United States
• PMID: 16598997 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Diplopia (etiology)
• Exophthalmos (etiology)
• Fungi (immunology)
• Humans
• Hypersensitivity (complications)
• Male
• Sinusitis (complications, diagnosis, immunology, surgery)