Could Fungus be Causing Your Chronic Sinusitis?

Could Fungus be Causing Your Chronic Sinusitis?

The most common causes of sinus infections are bacterial and viral, however, fungal sinus infections can also occur.  In some cases, fungal sinusitis may be the underlying culprit in chronic sinus issues.

Diagnosis of fungal sinusitis is often delayed because the symptoms are similar to chronic bacterial sinusitis. Typical symptoms can include sinus headache, nasal congestion, facial pain or pressure, and cough.

Fungi love a damp and dark environment and the moist, dark cavities of the sinuses can make an ideal home for these invading organisms.

There’s estimated to be well over a million existing fungal species. Mold, yeast, and other fungi are common and pervasive throughout our environment.  Present in the air we breathe, on surfaces, and within our own bodies, exposure is inevitable.  Simply breathing will regularly deposit fungal elements within the nose and sinuses and typically their presence is of little consequence.

However, in some instances, disease and illness can result, ranging in varying degrees of severity.   Fungal sinusitis comes in many forms but the condition is broadly classified into non-invasive and invasive types.  Here’s what you need to know:

Non-Invasive Fungal Sinusitis

Allergic fungal sinusitis

Allergic fungal sinusitis (AFS) is the most common type of fungal sinus infection. The condition occurs when an individual is exposed to the infecting fungi through the natural process of nasal respiration, causing an allergic response that produces thick fungal debris, sticky mucus, and inflammation. The sinuses become blocked or obstructed, impeding normal sinus drainage and creating an environment ripe for the fungus to grow and colonize. As a result, patients can develop chronic sinusitis and may also often have a history of chronic sinusitis, allergies, asthma, or nasal polyps.

Diagnosis of AFS can be confirmed by lab testing of  a mucous sample for signs of fungi. Treatment involves removal of the fungal debris and clearing out the infected sinuses. Saline irrigations and anti-inflammatory medications can be typical treatment courses. Endoscopic sinus surgery may also be necessary.

Mycetoma fungal sinusitis or “fungus ball”

Mycetoma fungal sinusitis is a type of non-invasive fungal sinusitis. Essentially, it’s an overgrowth of fungal elements that produce a dense clump of spores or a fungus ball within the sinus cavity.

Patients who suffer from chronic sinusitis or who have had previous sinus surgery may be particularly prone to developing the condition. When years of stale mucus accumulates and becomes trapped in the larger sinus cavities, fungi will begin to grow and feed off the mucous and dead cells there. Over time, the fungi will continue to collect, forming into a dense ball of mold and debris, with a thick peanut butter like consistency.

The presence of a fungal ball can be detected through a CT or MRI scan. Generally, treatment involves removal of the fungus ball through endoscopic sinus surgery or in some cases, with transantral balloon dilation. Removal of fungal ball is usually performed through an in-office procedure.

Invasive Fungal Sinusitis

Invasive types of fungal sinusitis are much more unusual as it is extremely rare for fungi to attack living tissue.  Invasive forms of fungal sinusitis can be life-threatening and early detection and prompt treatment may be critical to survival.

These serious infections are most likely to occur in immunocompromised patients, such as individuals undergoing chemotherapy or with uncontrolled diabetes mellitus.

With invasive forms of fungal sinusitis, fungus can grow rapidly through the sinus tissues and bone, causing tissue death and spreading into the surrounding areas of the brain and eye. Treatment requires a combination of aggressive surgical and meditational therapy.

While invasive fungal sinusitis can be dangerous and deadly, these types of infections are extremely uncommon.

If you experience chronic sinusitis or suspect fungal infection may be the root of your sinus issues, we can help you find the relief you need. Give us a call and schedule an appointment at the Ohio Sinus Institute today.