ENT · Nose and Paranasal Sinuses (Anatomy, Sinusitis, Polyps, Epistaxis)

Allergic fungal sinusitis (AFS) is characterised by all of the following EXCEPT:

  • A Type I hypersensitivity (IgE-mediated) to fungal antigens with eosinophilic mucin
  • B Fungal invasion of the mucosal vessels and bone with tissue necrosis ✓
  • C Radiological finding of heterogeneous opacification with central hyper-attenuation on CT (eosinophilic mucin)
  • D Histological presence of allergic mucin with Charcot-Leyden crystals and non-invasive fungal hyphae
Correct answer: B. Fungal invasion of the mucosal vessels and bone with tissue necrosis

Explanation

Allergic fungal sinusitis is a non-invasive form of fungal sinusitis characterised by: type I and type III hypersensitivity to fungal antigens (most commonly Bipolaris, Curvularia, Aspergillus), thick eosinophilic mucin (allergic mucin) containing Charcot-Leyden crystals and non-invasive hyphae, elevated serum IgE, peripheral eosinophilia, and characteristic CT appearance of heterogeneous sinus opacification with central hyperdense foci (calcified mucin). Vascular invasion, tissue necrosis, and bone destruction are features of INVASIVE fungal sinusitis (angioinvasive aspergillosis in immunocompromised patients), not AFS.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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