Fungal Sinusitis: Understanding and Addressing Fungal Sinusitis in Woodbury, CT

Symptoms of Fungal Sinusitis

The symptoms of fungal sinusitis mirror those of other forms of sinusitis, including nasal congestion, facial pain or pressure, loss of smell, and nasal drainage. In severe cases, fungal sinusitis in individuals with compromised immune systems can lead to notable changes in skin color, numbness of the face, and facial swelling.

Four Types of Fungal Sinusitis

1. Saprophytic Fungus: Occurs when fungus or mold grows on mucus or mucous crusts inside the nose. Treatment involves the removal of crusts through nasal washes or other methods.
2. Fungus Ball: Caused by fungus getting trapped in a sinus, forming clumps of material. Surgery is often required to open and wash out the sinus.
3. Allergic Fungal Sinusitis (AFS): Results from an allergic reaction to common fungi, leading to symptoms of nasal congestion, runny nose, and sneezing. Surgery is necessary for treatment, and recurrence is common without continued medical therapy.
4. Invasive Fungal Sinusitis: A severe infection that can lead to the destruction of nasal/sinus tissue. There are three subtypes of Invasive Fungal Sinusitis and treatment options vary based on the specific type.

• • Chronic Indolent/Granulomatous Sinusitis is a very rare disease which is usually not seen in the United States. Patients have a normally functioning immune system but for some reason the presence of the fungus results in a severe immune response that destroys the lining of the nose.
  • Chronic Invasive Sinusitis is seen in patients who do not have a normally functioning immune system. Typically, this is seen in patients with diabetes. The fungus invades the tissue of the sinuses, but the disease progresses very slowly.
  • Acute Fulminant Invasive Fungal Sinusitis is seen in patients who do not have a functioning immune system. Severe diabetics, transplant patients, and those with lymphoma or leukemia are at the highest risk. In this disease the fungus invades and destroys blood vessels that line the nose resulting in the death of that tissue. This is a life-threatening disease and often requires emergency surgery and anti-fungal medications.

Diagnosis and Treatment

Typical treatment options are noted in the individual causes of fungal sinusitis described above. Frequently, some sort of surgery or procedure is required to physically remove the fungus, the mucus that contains it, and sometimes the tissue that has been affected.

Antifungal medications can be used as well, but usually not without a surgery. There have been some studies that indicate that antifungal medications called “azoles,” such as itraconazole, can be useful in treating allergic fungal sinusitis. With invasive fungal sinusitis, use of antifungal medications is required.

What Questions Should I Ask My Doctor?

1. 1. How can we determine if fungus is involved in my sinusitis?
   2. Should we consider oral or topical antifungal treatments?
   3. What type of surgery might be needed?
   4. Is more than one surgery necessary?