Updates in the Classification of Fungal Sinusitis

Daniel P. Lander, Lauren T. Roland

Research output: Contribution to journalReview articlepeer-review


Purpose of review: This review aims to present the current classification schema for fungal rhinosinusitis, highlight current topics of interest, and identify potential areas for improvement and further research. Recent findings: There have been recent concerns that the allergic fungal rhinosinusitis (AFRS) criteria may be too stringent, leading to missed diagnoses. Additionally, many individual components of the AFRS criteria are non-specific. A “subacute” or “intermediate” category for invasive fungal sinusitis (IFS) has been proposed in addition to acute and chronic classifications. A new “microinvasive” variant of invasive fungal sinusitis has also been suggested. Recently, there have been reports of progression from non-invasive forms of fungal sinusitis to IFS in immunosuppressed patients. Summary: While diagnostic criteria have been published and widely accepted, there is a possibility that fungal sinusitis is a spectrum of disease both in terms of aggressiveness and invasiveness. There is a vast opportunity for multi-institutional studies, translational research, and updates to the classifications and guidelines for fungal sinusitis.

Original languageEnglish
Pages (from-to)93-105
Number of pages13
JournalCurrent Treatment Options in Allergy
Issue number2
StatePublished - Jun 2023


  • Acute invasive fungal sinusitis (AIFS)
  • Allergic fungal rhinosinusitis (AFRS)
  • Chronic invasive fungal sinusitis (CIFS)
  • Diagnosis
  • Fungal ball
  • Saprophytic


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