Xu Tao, Guo Xiao-Tao, Zhou Yi-Cui, Zhou Qian, Wang Yin-Feng
Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.
Ear Nose Throat J. 2023 Apr 5:1455613231167247. doi: 10.1177/01455613231167247.
Allergic fungal rhinosinusitis (AFRS) is characterized by refractory and high recurrence rate. Improper treatment may lead to repeated recurrence and even serious complications, including vision loss, blindness, and intracranial complications. However, AFRS is easy to be misdiagnosed clinically.
To ensure early diagnosis, the clinical presentations of patients with AFRS were studied.
Data from patients with sinusitis hospitalized in the First Affiliated Hospital of the University of Science and Technology of China (USTC) from January 2015 to October 2022 were collected. The patients were divided into three groups; group A patients with AFRS, group B patients suspected of AFRS, and group C patients with fungus ball sinusitis (FBS).We retrospectively analyzed the data using IBM SPSS 19.0 to perform the chi-square test and one-way ANOVA test.
In total, 35 cases of AFRS, 91 cases of suspected AFRS, and 661 cases of FBS were rediagnosed. Compared with FBS patients, AFRS patients were younger, the total IgE, the percentage of eosinophils and basophils in peripheral blood were higher, and the proportion of patients with allergic rhinitis, asthma or hypo olfactory was higher. It had a higher recurrence rate. These results were also observed in the comparison between suspected AFRS patients and FBS patients, but no significant difference was found in the comparison between suspected AFRS patients and suspected AFRS patients.
AFRS may be misdiagnosed due to the low detection of fungi. To ensure early diagnosis, we recommend that patients with clinical, radiological, and laboratory features similar to those of AFRS but without evidence of fungal staining be treated according to the treatment criteria of AFRS.
变应性真菌性鼻-鼻窦炎（AFRS）的特点是难治且复发率高。治疗不当可能导致反复复发，甚至引发严重并发症，包括视力丧失、失明和颅内并发症。然而，AFRS在临床上容易被误诊。
为确保早期诊断，对AFRS患者的临床表现进行了研究。
收集了2015年1月至2022年10月在中国科学技术大学附属第一医院住院的鼻窦炎患者的数据。将患者分为三组：A组为AFRS患者，B组为疑似AFRS患者，C组为真菌球性鼻窦炎（FBS）患者。我们使用IBM SPSS 19.0对数据进行回顾性分析，以进行卡方检验和单因素方差分析。
共重新诊断出35例AFRS、91例疑似AFRS和661例FBS。与FBS患者相比，AFRS患者更年轻，外周血总IgE、嗜酸性粒细胞和嗜碱性粒细胞百分比更高，变应性鼻炎、哮喘或嗅觉减退患者的比例更高。其复发率更高。在疑似AFRS患者与FBS患者的比较中也观察到了这些结果，但在疑似AFRS患者之间的比较中未发现显著差异。
AFRS可能因真菌检测率低而被误诊。为确保早期诊断，我们建议对于临床、影像学和实验室特征与AFRS相似但无真菌染色证据的患者，应按照AFRS的治疗标准进行治疗。
