Drean Ferrys Widhiono, - and Budi Sutikno, Budi A Rare Case of Allergic Fungal Rhinosinusitis in Indonesian Elderly: A case Rport and Diagnostic Procedure. Annals of Medicine and Surgery, 66. ISSN 8102400

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Abstract

Abstract 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.

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