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An algorithmic approach to aspergillus sinusitis

Published online by Cambridge University Press:  29 June 2007

D. W. Denning
Affiliation:
Senior Lecturer, University of Manchester, Hope Hospital and Monsall Hospital (Co-ordinating centre for the European Invasive Aspergillus Group).

Abstract

The effective management of paranasal sinus aspergillosis requires early diagnosis, histological classification, surgery and where appropriate, chemotherapy. Fungal sinusitis may be easily missed unless a high index of suspicion is maintained and specific culture and histology requested. The disease is classified into invasive and noninvasive types, each being divided into two subgroups: invasive aspergillosis may be either fulminant or indolent and noninvasive disease localized or allergic. The literature is reviewed and an algorithmic approach to aspergillus sinusitis proposed. The importance of histologically differentiating invasive from noninvasive aspergillosis prior to selecting the appropriate treatment options is stressed. CT scan should precede definitive surgery, and be used in follow-up. Close and prolonged follow-up is essential.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1994

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