Ask a Doctor: Allergic Fungal Sinusitis

Introducing: Ask a Doctor

At UTHSC ENT, we understand that patients need clear, helpful answers to their questions. We also know that a flood of new information can be overwhelming.

That’s why our department’s introducing Ask a Doctor: an ongoing series of posts that tackle Frequently Asked Questions about common issues. We hope these articles give you a better understanding of your situation and an easy path to treatment.

So far, our posts have largely focused on sinus and allergy issues. Today, we tackle AFS (Allergic Fungal Sinusitis).

Prepared by: Tracy Cherian
Reviewed by: Dr. Sanjeet Rangarajan

What is Allergic Fungal Sinusitis (AFS)?

Allergic Fungal Sinusitis (AFS) is a sub-type of chronic sinusitis. AFS is caused by an inflammatory reaction against fungi in the sinus tract, which blocks the normal sinus drainage.

What are its causes and symptoms?

AFS is caused by several different types of fungi found in the environment.

While many people have fungi residing in their nose and sinus tract, some develop an allergic reaction toward the fungi. AFS is prevalent in warm and humid climates–like Memphis!

AFS occurs in all age groups, but people typically present symptoms between adolescence and young adulthood. There is a higher rate of AFS among males and patients with a history of asthma or allergic rhinitis.

Symptoms include (but are not limited to):
-Nasal congestion
-Nasal drainage
-Nasal polyps
-Facial pressure
-Headaches

Additionally, the nasal mucus can be green, brown, or grey with a foul odor. It typically has consistency similar to chunky peanut butter, clay, or even cement.

How will my doctor diagnose AFS?

Diagnosis of AFS is largely based on your symptoms and history of allergic responses. Your doctor may also consider AFS if you have not experienced symptom relief with traditional therapy such as antihistamines.

A physical exam finding of nasal polys, characteristic signs on CT imaging, and the presence of fungal organisms on pathology specimen can further confirm a diagnosis of AFS.

What are my treatment options?

Treatment is primarily surgical removal of fungal mucus and restoration of normal sinus drainage. However, surgery is not curative and oral or nasal spray corticosteroids are needed to suppress continued inflammation.

The role of antifungal medications in treating AFS is currently not recommended, so they are not commonly prescribed in AFS management.

Are there potential complications?

AFS recurrence is common, patients typically respond well to treatment.

However, if AFS is left untreated, the buildup of mucus and inflammation could lead to breakdown of surrounding bone and tissue. This progression of AFS can result in worsening of nasal symptoms, expansion of the mucus into the brain, bulging of the eyes, and visual symptoms.

If you have been told you have allergic fungal sinusitis or another related condition, let us help you formulate a treatment plan to improve your symptoms and prevent future complications.

How can our Dream Team help?

UTHSC ENT’s Dream Team provides world class treatment in your hometown, and our sinus & allergy division is nationally-renowned.

While allergic fungal sinusitis is common and treatable, you need our rhinology specialists to diagnose and treat your issue as soon as possible. We’d love to hear from you!

Schedule your consultation today: (901) 866-8384