City Allergy

Category: For Allergy Fellows > Topics for Medical Professionals  

Chronic Sinusitis: Antifungal Therapy Response

Antifungal therapy of chronic sinusitis is a controversial topic.  Studies are conflicting but that may not be so surprising.  Chronic sinusitis is a heterogeneous disease with multiple subtypes.  Our experience with antifungal therapy is that it works in select cases.  This man had rapid recurrence of nasal polyps after sinus surgery.  At the time of initial nasal endoscopy his only medication was Singulair (montelukast) 10 daily.  Nasal itraconazole was initiated with dramatic symptomatic and endoscopic response.  An interruption in the topical antifungal therapy resulted in rapid polyp growth which improved when itraconazole was reinstituted.  There were no other interventions.