An Update on the Criteria for Diagnosing Allergic Fungal Rhinosinusitis: A Review of the Literature

Abstract

Allergic fungal rhinosinusitis (AFRS) is a type of hypersensitive inflammatory response that causes chronic, recurrent, and noninvasive hypertrophic sinus disease. The aim of this paper is to report the latest information and development in the diagnostic conundrum that allergic fungal rhinosinusitis can present. A literature review was conducted of PubMed English language search of current diagnostic criteria for allergic fungal rhinosinusitis, from 1951 to 2017. The diagnosis of allergic fungal rhinosinusitis needs to be considered in all patients with severe chronic rhinosinusitis with nasal polyposis. Patients often have asthma and complain of thick ‘wallpaper glue’ like nasal secretions that can also often be seen on nasal endoscopy. CT scanning often shows heterogeneity and MRI scanning may also help to identify cases. The diagnostic role of total and fungus-specific IgE in AFRS requires further prospective evaluation. The role of genetic and immunological testing in AFRS requires developing as diagnostic tools. The diagnosis is therefore often a clinical one supported by investigations such as radiology