Allergic fungal sinusitis

Case contributed by Dr Dalia Ibrahim

Presentation

Chronic left nasal obstruction and discharge

Patient Data

Age: 25
Gender: Male
Modality: CT

Expanded left maxillary antrum, left ethmoidal complexes and the left side of the frontal sinus. They show complete inhomogeneous opacification with hyperdense material is seen located centrally surrounded by hypodense mucosa.

Modality: MRI

The examined sinuses show internal high signal at T1 WI and signal void at T2 WI.

Contrast enhancement of the mucosal lining.

No intra-cranial or intra-orbital extension.

Case Discussion

Allergic fungal sinusitis (AFS) is the most common form of fungal sinusitis and is common in warm, humid climates.

The majority sinuses show near complete opacification. On unenhanced CT the sinuses are typically opacified by centrally (often serpentinous) hyperdense material with a peripheral rim of hypodense mucosa. 

Approximately 40% of patients may have each of the following features:

  • expansion of an involved sinus
  • remodelling and thinning of the bony sinus walls
  • erosion of the sinus wall.
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Case Information

rID: 29086
Case created: 2nd May 2014
Last edited: 21st Nov 2016
System: Head & Neck
Inclusion in quiz mode: Included

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