What Is Fungal Sinusitis?
Sinusitis is the medical term for inflammation of the sinuses. There are several possible causes of sinusitis, including an infection with a virus (the most common cause), bacteria, or fungus. Fungal
sinus infections are quite rare.
Types of Fungal Sinus Infections
There are several different types of fungal sinus infections. Some are mild; others can be quite serious, especially in those with a weakened immune system.
One serious form is known as invasive fungal sinusitis. The acute form of these infections can be particularly serious because damage can quickly occur in the sinus bones, which allows the infection to get into the eye and brain. There is also a chronic form, known as chronic invasive fungal sinusitis, although it tends to be less serious than the acute form.
Who's at Risk for an Invasive Infection?
People most at risk for a more serious type of fungal sinus infection are those who have a weakened immune system. This can include people with:
- Cancer that affects cells in the blood
- Low blood counts from chemotherapy
- HIV or AIDS
- Uncontrolled diabetes.
This also includes people who have had an organ transplant or bone marrow transplant.
Symptoms of acute invasive fungal
sinusitis usually develop quickly and can include:
- Fever
- Pain in the face
- Cough
- Nasal congestion
- Bloody nose
- Change in vision or mental status.
These infections are quite serious; in some cases, they can even cause loss of life. Getting prompt treatment is very important.
Fungal infections can also be chronic (allergic fungal sinusitis and chronic invasive fungal sinusitis). In these cases, the symptoms are similar to those of
chronic sinusitis (nasal stuffiness, discharge, pressure in the face, cough). With chronic invasive fungal sinusitis, a person may also have changes in vision and decreases in eye movement. With allergic fungal sinusitis, a person may have bulging of one or both eyes.
How Is Fungal Sinusitis Diagnosed?
When a healthcare provider suspects a fungal sinus infection, he or she will order several tests, including a computed tomography (CT) and magnetic resonance imaging (MRI) of the sinuses. He or she will then look into the sinuses using a lighted camera. A small piece of tissue (biopsy) will then be removed. If fungi are seen in this biopsy, a diagnosis of a fungal sinus infection is made.
Surgery is recommended in most cases of fungal sinusitis. This procedure is used to clean out as much of the infection as possible and restore drainage and air flow to sinuses. In some cases, surgery may be the only treatment needed. For invasive forms of this sinus infection, antifungal medicines may also be necessary.
Some types of fungal sinusitis respond well to medicines and/or surgery, although the condition can come back even after successful treatment.
Acute invasive fungal sinus infections can be difficult to cure; this is because most people with this type of infection have weakened immune systems to begin with. For the best chance of curing the infection, early treatment is important. The course of treatment can be anywhere from a couple of weeks to months, depending on how the person responds.
Once the infection has been cured, some people may need to continue their antifungal medicine for several more months to prevent an infection from returning. Others, such as those with especially weakened immune systems, may require preventive antifungal medicines for the rest of their lives.
