What is fungal sinusitis?
Fungal sinusitis is defined as the infection of the sinuses caused by fungi. Fungal infection of sinuses has recently been blamed being the most common cause of cases of chronic rhinosinusitis.
Fungal infections of the paranasal sinuses are uncommon and the cases of fungal sinusitis are increased in the immuno competent population.
Different types of fungal infection?
Different types of sinusitis with there pathologies are given as under:
Mycetoma fungal sinusitis
In this type of sinus infection, there is the production of clumps of spores, fungal ball within the cavity of sinus mostly maxillary sinus. They does not cause a significant inflammatory response but slight sinus discomfort was there.
Allergic fungal sinusitis
This type is believed to be an allergic reaction to environmental fungi which are dispersed into the air. In this thick fungal debris and mucin are developed in the sinus cavities.
Chronic indolent sinusitis
This is an invasive form of fungal sinusitis especially in immune deficient patients. It is characterized by a granulomatous inflammatory infiltrate.
Fulminant sinusitis
Fulminant sinusitis is mostly seen the immuno compromised patients. Majorly this leads to the destruction of the sinuses and can invade the cavities containing eyeball and the brain. Chronic sinus infections are due to fungus exposure.
Who are affected?
Individuals of any race, any sex and of any age can be affected by fungal sinusitis.
What are the common organism that causes fungal sinusitis?
Allergic fungal sinusitis is caused by following organisms:-
-Curvularia lunata.
-Aspergillus fumigates.
-Bipolaris.
-Drechslera.
Sinus mycetoma are caused by following organisms:
-Fumigates.
-Dematiaceous fungi.
Invasive type, Acute fulminant type, the chronic and granulomatous types are caused by following fungi:
-Rhizopus.
-Rhizomucor.
-Absidia.
-Mucor.
-Cunninghamella.
-Mortierella.
-Saksenaea.
-Apophysomyces species.
Fumigates is the only fungus type which is associated with chronic invasive fungal sinusitis.
Granulomatous invasive fungal sinusitis is caused by Aspergillus flavus fungi.
What are the symptoms of fungal sinusitis?
Different type of fungal sinusitis gives a different type of signs and symptoms and are explained below: –
Allergic fungal sinusitis presents the following symptoms: –
-Facial pressure.
-Headache.
-Nasal stuffiness.
-Discharge.
-Cough.
-sometimes proptosis or eye muscle entrapment is seen.
Acute invasive fungal sinusitis show the following symptoms: –
-Patient is very sick with fever.
-Cough.
-Nasal discharge.
-Headache.
-Mental status changes.
-dark ulcers present on the septum, turbinates or
palate.
Chronic invasive fungal sinusitis also includes proptosis.
What are the investigations for fungal sinusitis?
The following test will indicate the presence of fungal infection in sinuses: –
-Elevated levels of total fungus-specific IgE concentrations.
-Enzyme-linked immunoabsorbent assays are helpful in diagnosis.
-CT scan of paranasal sinuses.
-MRI helps in seeing the spread of infection.
-Histological findings also help to confirm the diagnosis of the type of fungal sinusitis affecting the patient.
What are the complications of fungal infection?
-Complications involve orbit and CNS.
-Necrosis and damage to the adjacent structures.
-Cavernous sinus thrombosis.
-Erosion in the orbit.
What is the treatment for fungal sinusitis?
Medications to be given are as follows:
-Systemic steroids.
-Immune therapy in specific allergens.
-Systemic anti-fungals.
-Anti-fungal medications.
-Surgical treatment is helpful
-Endoscopic lesion removal is performed when the lesion is accessible.
-Surgical debridement is also done to treat fungal sinusitis.
What is the homeopathic treatment for fungal sinusitis?
-Hydrastis
-Mercurius solibus
-Cuprum mettalicum
-Hepar sulphuris
