Allergic fungal rhinosinusitis accompanied by allergic bronchopulmonary aspergillosis: A case report and literature review

Impact of Climate Change on Indoor Air Quality

Climate change may affect the quality of the indoor environment through heat and mass transfer between indoors and outdoors: first by a direct response to global warming itself and related extreme weather phenomena and second by indirect actions taken to reduce greenhouse gas emissions that can lead to increased concentrations of indoor air contaminants. Therefore, both indoor and outdoor air pollution contribute to poor indoor air quality in this context. Exposures to high concentrations of these pollutants contribute to inflammatory respiratory diseases. Climate change adaptation and mitigation measures could minimize these risks and bring associated health benefits.

A rare case of allergic fungal rhinosinusitis in Indonesian elderly: A case report and diagnostic procedure

Background

Allergic fungal rhinosinusitis (AFRS) is a rare case.

Case presentation

A 63-year-old-man presented right nasal congestion one year ago. There was a polyp in the right nasal cavity supported CTScan showed a solid mass with central hyperattenuating of ±8.4 × 2.4 × 4.4 cm. Total IgE value was 1,227 IU/ml, while Aspergillus specific IgE and Mucorous specific IgE using the micro-Elisa technique were negative or less than 0.35 IU/ml. The skin prick test was positive on exposure to house dust, cotton, chicken meat, and cow's milk. Mucosal polypoid and allergic mucin were found during functional endoscopic sinus surgery (FESS). Histopathology showed inflammatory cells of eosinophils.

Discussion

These results lead to a diagnosis of AFRS according to the Bent and Kuhn criteria. The highest incidence rate is in adolescents and young adults but it occurs in the elderly. So, some of the signs and symptoms of AFRS in adolescents and young adults do not appear.

Conclusion

AFRS can only be diagnosed during FESS when mucins are found, this case appear in the elderly to be very interesting.

•Allergic Fungal Rhinosinusitis (AFRS) is a rare case in otorhinolaryngology.

•Diagnosis of AFRS can only be obtained during functional endoscopy sinus surgery (FESS).

•Hypersensitivity type 1, polyp nasi, typical CT Scan finding, and mucin during FESS were found.