Efficacy of Medical Therapy in the Management of Allergic Fungal Rhinosinusitis
Author(s): Abdulmalik Ismail, Jihan Al Maddah, Jude Alshamrani, Awadia Gareeballah, Rana A Aisa*
Abstract
Background: Allergic fungal sinusitis (AFS) or allergic fungal rhinosinusitis (AFRS) is a relatively common, condition that is believed to represent an allergic reaction to antigens from fungi that have colonized the sinonasal tract. Management of Allergic fungal sinusitis (AFS) is divided into medical and surgical management. In medical management, topical steroids, systemic steroids, and immunotherapy may be adjuncts to surgical treatment. Surgery remains to be the mainstay of treatment for AFRS. Up to our knowledge, no previous studies have described the effects of medical treatment as a solo treatment for AFRS. Case presentation: In this case report, we present a case of a patient with AFRS that resolved completely with medical therapy alone, and therefore her surgery was canceled. Our patient is a 40-year-old lady known asthmatic patient who presented to our clinic with a picture of right-sided allergic fungal sinusitis in 2015. The patient was started on medical therapy which included intranasal steroid and saline irrigation (0.5 mg of budesonide mixed with 250 ml normal saline, half of the mixture is given in the morning and a half at night) plus a short course of systemic steroids (prednisolone) and was booked for surgery. However, before her surgery date, the patient stated that a large piece of what appeared to be a polyp came out of her nose. A CT scan was repeated and showed near-total resolution of the disease. Conclusion: Management of AFS divided into medical and surgical, medical therapy alone can be effective in the treatment of AFRS, however, the disease recurrence may occur and surgical treatment is needed.