Fungal sinusitis encompasses various situations where fungus may contribute to nasal and sinus inflammation and symptoms. Fungi are a distinct “kingdom” separate from plants and animals. Unlike plants, they cannot produce their own food and rely on absorbing nutrients from other organisms, including humans. While the body can typically combat fungal infections, certain conditions that weaken the immune system can facilitate fungal growth. These conditions include diabetes, leukemia or lymphoma, congenital immunodeficiencies, overuse of antibiotics, organ transplant medications, among others.
The symptoms of fungal sinusitis are similar to other types of sinusitis and may include nasal congestion, facial pain/pressure, loss of smell or foul odor in the nose, and nasal drainage. In individuals with compromised immune systems, fungal sinusitis can be severe, leading to changes in the skin, facial numbness, and swelling of the cheeks or eyelids.
There are four types of fungal sinusitis:
Saprophytic Fungus: This occurs when fungus or mold grows on mucus or mucous crusts in the nose, without actually infecting the nasal tissue. Treatment involves the removal of crusts through nasal washes or other methods.
Fungus Ball: Fungus becomes trapped in one of the sinuses, forming clumps of material that may also contain bacteria. This typically occurs in the maxillary sinus and is often asymptomatic until it grows large enough to block the sinus. Treatment involves surgical opening and cleaning of the sinus, with anti-fungal therapy usually unnecessary.
Allergic Fungal Sinusitis (AFS): This type results from an allergic reaction to common fungi and typically occurs in individuals with a healthy immune system. Symptoms resemble allergies with nasal congestion, runny nose, and sneezing. AFS can lead to the accumulation of thick mucus in the sinuses, requiring surgical treatment. Continued medical therapy is necessary to prevent recurrence.
Invasive Fungal Sinusitis: This severe infection can cause the destruction of nasal and sinus tissue. There are three forms: Chronic Indolent/Granulomatous Sinusitis, Chronic Invasive Sinusitis, and Acute Fulminant Invasive Fungal Sinusitis. Treatment depends on the type and ranges from surgical intervention to emergency surgery and anti-fungal medications.
Treatment for fungal sinusitis typically involves surgical procedures to remove the fungus, affected tissue, and mucus. Antifungal medications, particularly azoles like itraconazole, may be used in conjunction with surgery, primarily for allergic fungal sinusitis. Invasive fungal sinusitis necessitates the use of antifungal medications.
Note: It’s important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan for fungal sinusitis.