New tools to diagnose Allergic Fungal Sinusitis (AFS) have the potential to reduce the need for surgery.

Allergic Fungal Sinusitis (AFS) is a common type of fungal infection which affects the sinuses. The infection is caused by fungi found in the environment and leads to an allergic reaction in patients, resulting in very thick mucus, fungal debris collecting in the sinuses and blocked sinuses. Patients often have symptoms such as allergies, nasal polyps and sometimes asthma. If left untreated, AFS can develop into a chronic condition, Fungal Chronic Rhinosinusitis (FCRS), affecting the senses of smell and sight. 

A new study by researchers in France provides useful information that can help clinicians to diagnose AFS before patients develop FCRS that requires surgery.

The researchers studied a group of 75 patients for 12 months, who had all been recommended for surgery to treat their FCRS. They looked for a variety of criteria that would have allowed the diagnosis of AFS before surgery, these included: 

  • Blood tests to look for immune system markers such as immunoglobulin E and white blood cells
  • CAT scans
  • MRI scans
  • Microscopic examination of the debris and mucus found in the sinuses

The study found that Aspergillus was the most commonly isolated type of fungus in the study (65%) and results suggest that AFS can be reliably diagnosed by measuring total and anti-Aspergillus IgE levels and undertaking sinus MRI and CT scans.

Currently, definitive diagnosis of AFS is only confirmed after surgery has taken place by studying the material recovered from the sinuses. Describing new diagnostic indicators will help to support the decision to undergo complete surgical removal of fungal debris and mucus plugs from patients with CRS. 

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