Fungal Sinusitis

Fungal sinusitis occurs when the sinus cavities become inflamed due to inhaled fungi. Fungi are plant-like organisms that have no chlorophyll and as a result, they feed from dead organic matter. Just like bacteria, fungi can break down almost every type of complex organic substances. Sometimes fungus begins eating an organism that are still alive, especially when the body's immune system is suppressed and this results in inflammation of the sinus cavities.

Fungi are comfortable in dark and moist environments like sinuses. They are neither animals nor plants and are classified in a category of their own. A warm humid climate may enhance fungal growth and amplify allergic reactions.

They can reproduce in the absence of light or food. Fungus includes- molds, yeasts, mushrooms and puffballs.

Characteristic features of fungal sinusitis have the same signs and symptoms of chronic sinusitis, which is unresponsive to antibiotic therapy.

Types of fungal sinusitis

Fungal sinusitis is a serious condition that is either invasive of noninvasive. There are four types of fungal sinusitis and we present them according to whether they are invasive or noninvasive-

-Invasive fungal sinusitis

This condition is typically encountered in patients whose immune system is suppressed and/or have diabetes mellitus, AIDS symptoms and excessive alcohol consumers. Patients who have this condition are generally non allergic and it is common in patients who has chronic sinusitis. Invasive fungal sinusitis is commonly caused by Aspergillus fungus and can be recognized and differentiated from Allergic fungal sinusitis by the following factors.

• Nasal obstruction
• One sided facial pain
• Inability to move the eyes

  There are two types of invasive fungal sinusitis:

  Chronic indolent sinusitis

  This is when fungi invade a patient's body that does not have an immune deficiency. This chronic indolent sinusitis can progress for months to years and leads to chronic headaches and facial swelling.

  Fulminant sinusitis

  This is where fungi invade a patient's body that has a deficient immune system. It can lead to the destruction of the sinuses as well as invade the bony cavities that protect the eyeball and brain.

-Noninvasive fungal sinusitis

Noninvasive fungal sinusitis is more common in patients with allergic rhinitis, asthma, chronic sinusitis and nasal polyps. It also manifest itself through tissue destruction.

There are two types of noninvasive fungal sinusitis:

  Mycetoma fungal sinusitis

It produces clumps of spores within the sinus cavity (maxillary or sphenoid sinuses). The fungus usually does not cause significant inflammatory response, but sinus discomfort can occur. This condition is commonly caused by Fumigatus and Dematiaceous fungus.

Allergic fungal sinusitis

This is an allergic reaction to inhaled environmental fungi floating in the air, which causes thick fungal debris to develop in the sinuses. This condition is commonly caused by the following types of fungi: Culvalaria Lanata, Arspergillus Fumigatus, Bipolaris and Drechslera.