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We read with great interest the report by Geren et al¹ describing 2 cases of orbital involvement associated with allergic fungal sinusitis (AFS). Allergic fungal sinusitis is believed to be an allergic reaction to aerosolized environmental fungi in an immunocompetent host with a history of atopy.¹ This disease is characterized by chronic rhinosinusitis, nasal polyposis, allergic mucin, and the presence of fungal organisms.² The results of fungal cultures, however, are often negative because of sampling difficulty.¹ Orbital involvement is uncommon but can be caused by direct extension of sinus inflammation resulting in proptosis, ptosis, and diplopia.³ We found only 7 such patients described in English-language ophthalmic literature,¹ the first in 1983.⁴ To our knowledge, none have demonstrated the presence of a subperiosteal abscess related to AFS. We would like to add a unique case of AFS with orbital involvement associated with a large subperiosteal abscess.

A 40-year-old otherwise healthy man . . . [Full Text of this Article]

AUTHOR INFORMATION
Dale R. Meyer, MD; Kundandeep Nagi, MS