A patient with allergic fungal sinusitis (AFS) is distinguished from chronic invasive fungal sinusitis by all of the following EXCEPT:

• A Presence of eosinophilic mucin with Charcot-Leyden crystals
• B Elevated serum IgE and fungal-specific IgE
• C Characteristic CT findings of heterogeneous high-density mucin
• D Tissue invasion by fungal hyphae on histopathology ✓

Explanation

Allergic fungal sinusitis (AFS) is a non-invasive condition characterized by an IgE-mediated type I hypersensitivity response. Hallmarks include eosinophilic mucin with Charcot-Leyden crystals (but no tissue invasion), elevated total and fungal-specific IgE, nasal polyposis, and CT showing high-attenuation heterogeneous mucin due to concentrated fungal debris and calcium. Tissue invasion by fungal hyphae is the defining feature of invasive fungal sinusitis, which distinguishes it from AFS — tissue invasion is absent in AFS.

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

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Written and medically reviewed by the StethoPrep medical team.