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Allergic Aspergillus Sinusitis -Patient AM. A - The right sphenoid sinus is opacified and there is some involvement of the right ethmoids. Bony structures seem intact., B - Coronal section shows bilateral maxillary involvement with extensive mucosal thickening and some oedema of the turbinates., C - Extensive involvement of both maxillary sinuses, with soft tissue swelling. Swelling of both turbinates also visible., D - Marked involvement of ehmoidal air cells on the right , together with the inferior aspect of the sphenoid sinus. The left side is almost clear of disease.
A - The right sphenoid sinus is opacified and there is some involvement of the right ethmoids. Bony structures seem intact., B - Coronal section shows bilateral maxillary involvement with extensive mucosal thickening and some oedema of the turbinates., C - Extensive involvement of both maxillary sinuses, with soft tissue swelling. Swelling of both turbinates also visible., D - Marked involvement of ehmoidal air cells on the right , together with the inferior aspect of the sphenoid sinus. The left side is almost clear of disease. Allergic Aspergillus Sinusitis -Patient AM.

This patient underwent a right upper tooth extraction in 1960 with fracture of the root and a subsequent defect in the floor of the right maxillary antrum repaired in 2001. In 1970 he developed nasal polyps and later an episode of asthma. Polyps were removed in 1987 and 1997. He is not aspirin allergic.In July 1999 he developed pansinusitis with a full right maxillary sinus. Despite prior surgery and endoscopic surgery, disease progressed.In May 2002, fungal hyphae were seen in exudate from the right maxillary sinus, and Aspergillus fumigatus was cultured. Eosinophilic material and Charcot Leyden crystals were seen.

The scans in October 2001 show some improvement after 2 months itraconazole therapy.