Oretti Gabriele, Castellana Giuseppe, Manuguerra Roberta, Silini Enrico Maria, Ferri Teore
Azienda Ospedaliero Universitaria Parma - Departement of Otolaryngology.
Acta Biomed. 2019 Dec 23;90(4):563-567. doi: 10.23750/abm.v90i4.7832.
Fungal rhinosinusitis (FRS) is a clinical entity characterized by the presence of fungi within sino-nasal cavities that may occur in patients with normal or defective immunity. Allergic fungal rhinosinusitis (AFRS) is a form of non-invasive FRS that affects patients with an abnormal immuno-mediated response to fungal antigens. This article describes a case of isolated fronto-ethmoidal AFRS.
A 20-year old male patient presented with a history of a left nasal respiratory obstruction and allergic oculorhinitis. CT scans showed a polypoid mass in the left nasal cavity and opacification of the left ethmoid sinus, frontal recess and frontal sinus with hyperdense component. The patient underwent functional endonasal sinus surgery (FESS) with removal of nasal polyps from the left nasal cavity and of cheesy-like material and dense mucus from the left ethmoid and frontal sinus. Histological examination showed presence of fungal hyphae within the allergic mucus; a diagnosis of AFRS was made.
Follow up at 14 months showed no signs of recurrence.
The AFRS case reported herein is characterized by isolated unilateral fronto-ethmoid involvement, a rare presentation. Endoscopic nasal treatment was effective with complete patient recovery. (www.actabiomedica.it).
真菌性鼻窦炎（FRS）是一种临床病症，其特征为鼻窦腔内存在真菌，可发生于免疫功能正常或有缺陷的患者。变应性真菌性鼻窦炎（AFRS）是一种非侵袭性FRS，影响对真菌抗原有异常免疫介导反应的患者。本文描述了一例孤立性额筛窦AFRS病例。
一名20岁男性患者有左侧鼻呼吸阻塞和变应性眼鼻炎病史。CT扫描显示左侧鼻腔有息肉样肿物，左侧筛窦、额隐窝和额窦混浊，有高密度成分。患者接受了鼻内镜功能性鼻窦手术（FESS），从左侧鼻腔切除鼻息肉，并从左侧筛窦和额窦清除奶酪样物质和浓稠黏液。组织学检查显示变应性黏液内有真菌菌丝；诊断为AFRS。
14个月的随访显示无复发迹象。
本文报道的AFRS病例的特征是孤立性单侧额筛窦受累，这是一种罕见的表现。鼻内镜治疗有效，患者完全康复。（www.actabiomedica.it）
