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Fungal Rhinosinusitis - Causes, Symptoms, Diagnosis, and Treatment

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At times, a fungal infection can affect the sinus cavities and produce congestion-like symptoms known as fungal rhinosinusitis. Read this article to know more.

Medically reviewed by

Dr. Oliyath Ali

Published At May 8, 2023
Reviewed AtMay 8, 2023

What Is Fungal Rhinosinusitis?

Fungal rhinosinusitis is a fungal infection of the sinus cavity. This could be caused due to various reasons. This condition may also be known as fungal sinusitis. The symptoms of this condition may be congestion of the nose and pain in the cheeks and forehead. Such conditions may affect a person when their immune system weakens. People who may be affected by conditions such as diabetes or leukemia are at a higher risk of acquiring this condition. Fungal infections may at times resolve with just anti-fungal treatment. At times even surgery may be required to treat the condition. Fungal infections of the sinus, if left untreated can even lead to the destruction of the mucus lining. This infection may even spread to the brain which may lead to death.

What Type of Organisms Are the Fungus?

A fungus is a living microorganism. It cannot synthesize its food, so it takes its supplements from decaying matter in the dirt, water, or plants where it lives. A fungal organism can thrive on surfaces, people, and other animals. A fungus can take many forms such as yeasts and mold. A few growths are sufficiently large to see (like mushrooms), and some are so tiny that they can be visualized only under a microscope. There are more than 100,000 types of fungal growths. They may be just around us, and most aren't harmful. Be that as it may, a few growths can attack the body and increase the risk of serious medical conditions. there can be various fungal infections in the body such as oral thrush, vaginal thrush, infections of the nails, and candidiasis.

What Do You Mean by Sinus Cavities?

The sinuses are empty, interconnected spaces (holes) inside your skull. They stretch out across your temple, behind your nose, between your eyes, and under your cheekbones. Sinus walls have a layer of fluid that traps microscopic organisms and keeps the air inside wet. Sinuses need to habitually deplete. If there's a blockage or irritation, the sinuses do not work like they ought to.

What Are the Various Types of Fungus Infections of the Sinus Cavity?

The fungal infections of the sinus cavity may be classified as invasive and non-invasive. Non-invasive infections are more common and affect only the nose and sinus cavities. Invasive infections can spread to other parts such as the brain.

The various types of non-invasive fungal infections may include:

  1. Allergic Fungal Rhinosinusitis: This is the most well-known kind of fungal infection of the sinus. It results from an allergic reaction between the body and the organism. Untreated, the sinuses can lead to nasal polyps can frame. Individuals with asthma or previous history of allergies (roughage fever) are at a higher risk of developing this condition.

  2. Fungal Ball (Mycetoma): Fungi develop in the sinuses and structure into a bunch or ball. The contagious ball can get greater and block the sinuses. doctors use a medical procedure to eliminate fungal balls and clean the sinuses.

  3. Saprophytic Fungal Sinusitis: This condition does not affect the nasal mucosa directly. All things being equal, the organism develops on the mucosal crusting inside the nose. The doctors may use surgery to remove the crusting. This may also eliminate the parasites.

The various invasive fungal infections may include:

  1. Acute Fulminant Invasive Rhinosinusitis: This infection may also be known as acute invasive fungal sinusitis or Mucor mycosis. This condition occurs more frequently in people with weak immunity. Their immunity might be feeble because of various conditions associated with cancer, chemotherapy, or long steroid therapy. the fungal growth can destroy the nasal blood vessels. Without a blood supply, the tissues may begin to die. The infection may spread to the eyes and the brain. this infection may even lead to complications such as vision loss and even death.

  2. Chronic Invasive Rhinosinusitis: People with uncontrolled diabetes are at a greater risk of acquiring this condition. It is a long-standing condition and it does not spread quickly.

  3. Granulomatous Invasive Fungal Sinusitis (GIFS): This type of infection occurs when the body mounts a strong immune reaction to the organism. The body’s tissues are destroyed by its immune system.

How Common Is Fungal Rhinosinusitis?

This condition though not very common, can have severe complications. Some infections are more common than others. These fungal infections are more commonly observed in women. People with weak immunity are at a greater risk of acquiring this condition. This infection occurs more in warm and humid environments. Antibiotic exploitations can lead to this condition. Some conditions put a patient at greater risk to acquire these conditions which include:

  1. An HIV (human immunodeficiency virus)-positive patient.

  2. A patient affected by cancer has undergone chemotherapy.

  3. Long-standing and uncontrolled diabetes.

  4. Drugs that may weaken the immune system include those taken after transplant surgery.

What Are the Symptoms of Fungal Rhinosinusitis?

The symptoms of fungal sinusitis may include:

  1. Persistent nasal congestion and running nose.

  2. Decrease in smell perception.

  3. Fever.

  4. Pain in the cheeks and forehead.

  5. The feeling of heaviness in the head and forehead.

What Causes Fungal Rhinosinusitis?

This infection can be caused by various groups of the fungus family. It is mostly caused by mold or yeast. These can be most commonly found in our surrounding, but it affects only those with a weakened immune system.

How to Diagnose Fungal Rhinosinusitis?

The diagnosis of fungal rhinosinusitis can be done through the following means:

  1. Physical Examination: The doctor may perform a physical examination. The nasal cavity can be viewed using light. Also, the doctor may ask the patient to point out the areas where they experience pain.

  2. X-Ray: The doctor may advise an X-Ray to view the sinus cavities.

  3. CT scan (Computed tomography): The doctor may advise a CT scan to analyze the extent of the infection.

  4. Laboratory Test: Samples from the nasal tissues can be sent to the lab for tissue culturing. This aids in identifying the causative organism. Identifying the causative organism aids in devising an appropriate treatment plan.

  5. Endoscopy: It aids in visualizing internal structures. Endoscopy can also aid in localizing fungal balls if any are present.

What Is the Treatment for Fungal Rhinosinusitis?

The treatment for fungal rhinosinusitis varies from person to person. The causative organism also plays an important role in determining the treatment. For a healthy individual, this condition may resolve spontaneously. The various treatment options for fungal sinusitis may include:

  1. Medications: Medications can be prescribed by the doctor that may help cure the condition. An anti-fungal or steroid can be prescribed that can aid in curing the condition.

  2. Nasal Wash: Nasal wash can be prescribed to wash out the sinuses. This also helps in curing fungal balls.

  3. Surgery: Depending on the condition, the doctor may prescribe a surgical procedure. The procedure may be endoscopic or invasive.

Conclusion:

Since this condition is not a very common one, those who are at a higher risk of obtaining this condition should take precautionary measures. In case of any difficulties, medical attention should be obtained at the earliest.

Dr. Oliyath Ali
Dr. Oliyath Ali

Otolaryngology (E.N.T)

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