Bent & Kuhn Criteria for AFRS

The Bent & Kuhn Criteria are a set of diagnostic criteria to facilitate the diagnosis of allergic fungal rhinosinusitis.¹
Patients must meet all 5 major criteria to be diagnosed with Allergic Fungal Rhinosinusitis.
The minor criteria support the diagnosis but are not used to make the diagnosis itself.
Major Criteria
1. Type 1 Hypersensitivity
2. Nasal polyposis
3. Characteristic CT findings (serpiginous hyperdense material with a peripheral rim of hypodense mucosa, with or without expansion of the involved sinus wall).
4. Eosinophilic mucin without invasion
5. Positive fungal stain
Minor Criteria
1. Asthma
2. Unilateral disease
3. Bone erosion
4. Fungal cultures
5. Charcot-Leyden crystals
6. Serum eosinophilia

Major Criteria (5)	Minor Criteria (6)
Type 1 hypersensitivity to fungus	Asthma
Nasal polyposis	Unilateral disease
Characteristic CT findings	Bone erosion
Eosinophilic mucin without invasion	Fungal cultures
Positive fungal stain	Charcot-Leyden crystals
	Serum eosinophilia

Mnemonic for major criteria: PEN1S:
- P → Pathology (fungal stain)
- E → Eosinophilic mucin
- N → Nasal polyposis
- 1 → Type (1) hypersensitivity
- S → Scans (CT findings).
Mnemonic for minor criteria: ABCDEF:
- A → Asthma
- B → Bony erosion
- C → Charcot-Leyden crystals
- D → Directionality (ie. unilateral disease)
- E → Eosinophilia (serum)
- F → Fungal cultures.

Bent III, John P., and Frederick A. Kuhn. “Allergic fungal sinusitis/polyposis.” Allergy and Asthma Proceedings. Vol. 17. No. 5. OceanSide Publications, 1996. ↩

Last updated September 27, 2022