What is Fungal Rhinosinusitis?

M.R. Anglin

Rhinosinusitis usually refers to the inflammation of the paranasal sinuses, as well as the nasal mucosa. Fungal rhinosinusitis usually occurs when a fungus has infected the sinuses and is causing the inflammation. There are many different types of fungal rhinosinusitis, including allergic, acute fulminant, chronic invasive, and granulomatus. A fungus ball is another form. Treatment options may vary depending on the type of rhinosinusitis a person has.

The paranasal sinuses become inflammed in fungal rhinosinusitis.
The paranasal sinuses become inflammed in fungal rhinosinusitis.

The paranasal sinuses are cavities of air within a person’s skull. These cavities, as well as the nasal passages, are usually lined with mucus membranes. Normally, fungi are kept from invading by the immune system. If the immune system has been compromised, however, the fungus can cause an infection. In some cases, a person with a normal immune system can also become infected.

Symptoms of fungal rhinosinusitis may include fever.
Symptoms of fungal rhinosinusitis may include fever.

One form of fungal infection can be particularly quick and aggressive. The fungal infection that causes acute fulminant invasive fungal rhinosinusitis can last up to four weeks and can result in a patient’s death. This infection can destroy healthy tissue in the sinuses and could spread to the areas around the brain and eye within hours. Surgery is usually needed to remove any dead tissue and lesions, and an anti-fungal treatment is given to the patient to kill off the fungus. Symptoms may include fever, congestion, and pain.

The fungus that causes chronic invasive fungal rhinosinusitis usually spreads more slowly. Instead of invading the sinuses within hours, the fungus usually takes weeks or months to spread. Like in acute fulminant fungal rhinosinsusitis, treatment for this condition usually requires surgery, as well as a follow-up of anti-fungal medication. These conditions are often experienced by those with an abnormal immune system, such as those with diabetes. In addition, eye swelling and blindness could be experienced by a person with this form of rhinosinusitis.

An allergic reaction to mold may be the cause of allergic fungal rhinosinusitis. Someone with this condition may have sticky, yellow discharge that looks and feels like rubber cement. In order to properly diagnose the condition and to clean the sinuses of the infection, surgery is often needed. Granulomatous fungal rhinosinusitis, which occurs when the body develops what is known as granulomatous inflammation over a long period of time in response to funal organisms that have attacked sinus tissues. Cases of this type of fungal rhinosinusitis are most commonly found in Sudan and its surrounding areas. Treatment options usually include surgery. Fungal infections that cause this rhinosinusitis can be contracted by a person with a normal immune system.

A fungus ball is just that: a ball of fungal debris found in one of the sinuses. Usually, the sinus that is involved is the maxillary sinus, the cavity located within the cheekbones. Symptoms of fungus balls may include pressure, feeling as if the sinuses are full, and discharge. Often, a doctor will often have to remove the ball surgically.

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