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Fungal sinusitis "An article published in the Mayo Clinic Proceedings in September, 1999 by the Mayo Clinic suggests that fungal sinusitis may be much more common than previously thought. The disease is now know as EFRS (eosinophilic fungal rhinosinusitis) or EMRS (eosinophilic mucinous rhinosinusitis). Fungal growth was found in washings from the sinuses in 96% of patients with chronic sinusitis. Normal controls had almost as much growth, the difference being that those patients with chronic sinusitis had eosinophiles ( a type of white blood cell involved in allergic and other reactions) which had become activated. As a result of the activation, the eosinophiles released a product called MBP (Major Basic Protein) into the mucus which attacks and kills the fungus but is very irritating to the lining of the sinuses. We believe that MBP injures the lining of the sinuses and allows the bacteria to proliferate…..At the present time, patients are being treated with irrigation with topical antifungals such as Amphotericin B with 75 % having an improvement. Itraconazole (Sporanox) can also be used topically, but it is very difficult to make up since most mixtures cause the itraconazole to be inactivated immediately. Almost all pharmacies are unable to make it up correctly."


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