Allergic fungal sinusitis is a cross between a mold infection and a mold allergy.  Patients with AFS have pieces of fungal material trapped within their sinuses.  However, in its attempt to fight this invasion, the body develops an allergic type of reaction rather than a classic infectious reaction.  To the patient, this typically feels like sinus congestion and pressure often with thick brownish mucous production.  The mucous is often described as having the appearance of peanut butter. 

Over the preceding several months, the patient has usually already received multiple courses of antibiotics without benefit since antibiotics won’t kill a fungus.  A CT scan will typically reveal sinuses that are packed with inflammation and mucous.  In addition, your doctor may perform allergy skin tests and blood tests to help clarify the diagnosis.

Definitive diagnosis and treatment requires surgery to clean out all of the packed-in material and to show the fungal material and allergic cells trapped within.  Although surgery is always needed, if nothing else is done a relapse is extremely likely.  In order to stop the inflammation from recurring, steroid pills are started and tapered very slowly over the next year following surgery.  In some cases, allergy shots against molds and antifungal medications are also used although the true benefit of these therapies is still being determined.