Bush et al confuse the role of molds in chronic rhino-sinusitis (CRS). They accept the paradigm of allergic fungal rhinosinusitis and state that the criteria have been well delineated and that allergic fungal rhinosinusitis is readily distinguishable from typical CRS. They do not mention that these criteria have been established in patients who had been preselected to have these criteria present. ' Recent advances in the detection methods for the criteria have resulted in the demonstration of those criteria in the vast majority of CRS cases.4'5 The only exception is the presence of an IgE-mediated allergy to molds, which must be seen as a comorbid allergic rhinitis to molds#
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