Allergic Fungal Rhinosinusitis in a 12-Year-Old Male Resulting in the Remodeling of Cribriform Plate With Protrusion Into the Anterior Cranial Fossa: A Case Report

Allergic fungal rhinosinusitis (AFRS) in the pediatric population is a rare pathologic entity, and it is characterized by a type I hypersensitivity reaction to sinus fungi promoting the development of eosinophilic inflammation and thickened mucin. In the United States, a higher prevalence of AFRS is found among younger populations, African Americans, in counties characterized by elevated poverty rates, and patients without insurance or those reliant on Medicaid. Early clinical suspicion is essential for the timely diagnosis of this condition and to prevent the dissemination of the disease, thereby achieving a favorable prognosis. We report a case of a 12-year-old African American male who presented with the gradual onset of asymptomatic proptosis and seasonal allergy symptoms resulting in unilateral relative afferent pupillary defect and was ultimately diagnosed with AFRS.