Cochliobolus lunatus that the underlying disease is controlled, and immune modulators such as granulocyte-macrophage colony-stimulating factor and gamma interferon can be indicated when surgery or antifungals are not feasible alternatives. Allergic fungal manifestations include asthma, rhinitis, sinusitis and bronchopulmonary mycoses caused by a variety of etiological fungal agents including "C. lunatus". These agents provoke humoral immune responses, characterized by type I (immediate) and type III (immune complex mediated) hypersensitivity reactions. Prevalence of these diseases among the atopic population is 20-30 % and 6% in the general population. Allergic rhinitis, more commonly known as hay fever, is less frequently encountered in clinic compared
Allergic rhinitis of prolonged steroid therapy. Other measures that may be used second line include: decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies such as nasal irrigation. Topical decongestants may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods, as stopping them after protracted use can lead to a rebound nasal congestion called rhinitis medicamentosa. For nocturnal symptoms, intranasal corticosteroids can be combined with nightly oxymetazoline, an adrenergic alpha-agonist, or an antihistamine nasal spray without risk of rhinitis medicamentosa. Nasal saline irrigation (a practice where salt water is poured into the nostrils), may