Fungal rhinosinusitis

A categorization and definitional schema addressing current controversies

Arunaloke Chakrabarti, David W. Denning, Berrylin J. Ferguson, Jens Ponikau, Walter Buzina, Hirohito Kita, Bradley Marple, Naresh Panda, Stephan Vlaminck, Catherine Kauffmann-Lacroix, Ashim Das, Paramjeet Singh, Saad J. Taj-Aldeen, A. Serda Kantarcioglu, Kumud K. Handa, Ashok Gupta, M. Thungabathra, Mandya R. Shivaprakash, Amanjit Bal, Annette Fothergill & 1 others Bishan D. Radotra

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Background: Fungal (rhino-) sinusitis encompasses a wide spectrum of immune and pathological responses, including invasive, chronic, granulomatous, and allergic disease. However, consensus on terminology, pathogenesis, and optimal management is lacking. The International Society for Human and Animal Mycology convened a working group to attempt consensus on terminology and disease classification.Discussion: Key conclusions reached were: rhinosinusitis is preferred to sinusitis; acute invasive fungal rhinosinusitis is preferred to fulminant, or necrotizing and should refer to disease of <4 weeks duration in immunocompromised patients; both chronic invasive rhinosinusitis and granulomatous rhinosinusitis were useful terms encompassing locally invasive disease over at least 3 months duration, with differing pathology and clinical settings; fungal ball of the sinus is preferred to either mycetoma or aspergilloma of the sinuses; localized fungal colonization of nasal or paranasal mucosa should be introduced to refer to localized infection visualized endoscopically; eosinophilic mucin is preferred to allergic mucin; and allergic fungal rhinosinusitis (AFRS), eosinophilic fungal rhinosinusitis, and eosinophilic mucin rhinosinusitis (EMRS) are imprecise and require better definition. In particular, to implicate fungi (as in AFRS and EMRS), hyphae must be visualized in eosinophilic mucin, but this is often not processed or examined carefully enough by histologists, reducing the universality of the disease classification.A schema for subclassifying these entities, including aspirin-exacerbated rhinosinusitis, is proposed allowing an overlap in histopathological features, and with granulomatous, chronic invasive, and other forms of rhinosinusitis. Recommendations for future research avenues were also identified.

Original languageEnglish (US)
Pages (from-to)1809-1818
Number of pages10
JournalLaryngoscope
Volume119
Issue number9
DOIs
StatePublished - Sep 2009

Fingerprint

Mucins
Sinusitis
Terminology
Mycology
Mycetoma
Chronic Granulomatous Disease
Clinical Pathology
Hyphae
Immunocompromised Host
Nose
Aspirin
Mucous Membrane
Fungi
Infection

Keywords

  • Allergy
  • Aspergillus
  • Dematiaceous fungi
  • Fungal sinusitis
  • Zygomycetes

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Chakrabarti, A., Denning, D. W., Ferguson, B. J., Ponikau, J., Buzina, W., Kita, H., ... Radotra, B. D. (2009). Fungal rhinosinusitis: A categorization and definitional schema addressing current controversies. Laryngoscope, 119(9), 1809-1818. https://doi.org/10.1002/lary.20520

Fungal rhinosinusitis : A categorization and definitional schema addressing current controversies. / Chakrabarti, Arunaloke; Denning, David W.; Ferguson, Berrylin J.; Ponikau, Jens; Buzina, Walter; Kita, Hirohito; Marple, Bradley; Panda, Naresh; Vlaminck, Stephan; Kauffmann-Lacroix, Catherine; Das, Ashim; Singh, Paramjeet; Taj-Aldeen, Saad J.; Kantarcioglu, A. Serda; Handa, Kumud K.; Gupta, Ashok; Thungabathra, M.; Shivaprakash, Mandya R.; Bal, Amanjit; Fothergill, Annette; Radotra, Bishan D.

In: Laryngoscope, Vol. 119, No. 9, 09.2009, p. 1809-1818.

Research output: Contribution to journalArticle

Chakrabarti, A, Denning, DW, Ferguson, BJ, Ponikau, J, Buzina, W, Kita, H, Marple, B, Panda, N, Vlaminck, S, Kauffmann-Lacroix, C, Das, A, Singh, P, Taj-Aldeen, SJ, Kantarcioglu, AS, Handa, KK, Gupta, A, Thungabathra, M, Shivaprakash, MR, Bal, A, Fothergill, A & Radotra, BD 2009, 'Fungal rhinosinusitis: A categorization and definitional schema addressing current controversies', Laryngoscope, vol. 119, no. 9, pp. 1809-1818. https://doi.org/10.1002/lary.20520
Chakrabarti A, Denning DW, Ferguson BJ, Ponikau J, Buzina W, Kita H et al. Fungal rhinosinusitis: A categorization and definitional schema addressing current controversies. Laryngoscope. 2009 Sep;119(9):1809-1818. https://doi.org/10.1002/lary.20520
Chakrabarti, Arunaloke ; Denning, David W. ; Ferguson, Berrylin J. ; Ponikau, Jens ; Buzina, Walter ; Kita, Hirohito ; Marple, Bradley ; Panda, Naresh ; Vlaminck, Stephan ; Kauffmann-Lacroix, Catherine ; Das, Ashim ; Singh, Paramjeet ; Taj-Aldeen, Saad J. ; Kantarcioglu, A. Serda ; Handa, Kumud K. ; Gupta, Ashok ; Thungabathra, M. ; Shivaprakash, Mandya R. ; Bal, Amanjit ; Fothergill, Annette ; Radotra, Bishan D. / Fungal rhinosinusitis : A categorization and definitional schema addressing current controversies. In: Laryngoscope. 2009 ; Vol. 119, No. 9. pp. 1809-1818.
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