Mycology: allergic fungal rhinosinusitis: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Mycology: allergic fungal rhinosinusitis

Sample item

A 22-year-old atopic man has chronic nasal obstruction with polyps. At surgery, thick tenacious peanut-butter mucin is removed. Histology shows eosinophils and Charcot-Leyden crystals with scanty septate hyphae, none invading the mucosa. Which best explains the pathology?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Allergic response to fungal antigens in an atopic host

Allergic fungal rhinosinusitis, commonly caused by Aspergillus species and dematiaceous fungi in India, is a type I hypersensitivity reaction to fungal antigens in an immunocompetent atopic host. Eosinophilic mucin with Charcot-Leyden crystals and non-invasive hyphae is the hallmark, and treatment is surgical clearance with corticosteroids.

Option by option

  • A. Non-allergic fungal ball confined to one sinus

    A fungal ball lacks allergic mucin with eosinophils and involves a single sinus.

  • B. Allergic response to fungal antigens in an atopic host (correct)

    Correct. Eosinophilic mucin with non-invasive hyphae reflects hypersensitivity, not invasion.

  • C. Acute invasive disease in a neutropenic host

    Acute invasive disease in neutropenia shows tissue invasion and necrosis, which is absent here.

  • D. Angioinvasive hyphae in a ketoacidotic diabetic

    Angioinvasion with tissue necrosis occurs in ketoacidosis with mucormycosis and shows hyphae in vessels.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Allergic response to fungal antigens in an atopic host. Allergic fungal rhinosinusitis, commonly caused by Aspergillus species and dematiaceous fungi in India, is a type I hypersensitivity reaction to fungal antigens in an immunocompetent atopic host.

Why is "Non-allergic fungal ball confined to one sinus" not the answer?

A fungal ball lacks allergic mucin with eosinophils and involves a single sinus.

Why is "Acute invasive disease in a neutropenic host" not the answer?

Acute invasive disease in neutropenia shows tissue invasion and necrosis, which is absent here.

Why is "Angioinvasive hyphae in a ketoacidotic diabetic" not the answer?

Angioinvasion with tissue necrosis occurs in ketoacidosis with mucormycosis and shows hyphae in vessels.

What concept does this question test?

It tests Mycology: allergic fungal rhinosinusitis in Microbiology. Eosinophilic mucin with Charcot-Leyden crystals and non-invasive hyphae is the hallmark, and treatment is surgical clearance with corticosteroids.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mycology: allergic fungal rhinosinusitis?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.