What is Fungal Sinusitis?

Fungal sinusitis can be an acute or chronic infection in which the sinus cavities in the face become swollen, congested, and painful. There are many different forms of fungal sinusitis, characterized by the type of fungus involved and the nature of symptoms. The condition is usually mild, and symptoms resemble those of other types of sinusitis that occur after a person catches a cold. Occasionally, however, fungi can spread rapidly through the body and lead to potentially life-threatening complications. Some cases of fungal sinusitis can be treated with antifungal medications and corticosteroids, though most instances require surgical intervention to clear mucus and remove traces of the offending fungus.

Doctors recognize invasive and noninvasive types of fungal sinusitis. Noninvasive types are more common and generally milder. They tend to have a slow onset and cause lasting symptoms of cough, congestion, and headaches. Invasive fungal sinusitis tends to be an acute infection that produces immediate, severe symptoms. A person with the invasive variety often gets very sick, experiencing severe fatigue, fever, headaches, and nausea. Left untreated, acute fungal infections can impair heart, lung, and brain functioning.

Several different fungi can potentially infect the sinuses, though the most common pathogen is known as Aspergillus fumigatus. This fungus is found all over the world in soil, compost, and household mildew. When fungal spores are inhaled, they attach to the mucous membranes that line the nose and sinuses where they can trigger an allergic response in some individuals. People who suffer from immune system disorders or severe allergies are at a much higher risk of developing sinusitis after fungal exposure.

Fungal sinusitis can be diagnosed by a specialty doctor called an otolaryngologist. The doctor can recognize a fungal infection by analyzing symptoms, peering into the nasal cavity with an endoscope, and interpreting computerized tomography scans of the face. A tissue biopsy or mucus sample may be collected for laboratory tests to confirm the type of fungus involved.

A doctor may try to treat noninvasive fungal sinusitis with oral medicines designed to attack fungi and reduce the immune system's response to the pathogen. Fungi can be very resistant to drugs, however, and often need to be removed through surgery. Acute fungal sinusitis nearly always requires surgery. A skilled surgeon can conduct a minimally invasive procedure to manually cut away fungus and damaged sinus tissue.

Mild cases tend to respond very well to surgery, and patients tend to recover from symptoms within one month. Procedures to treat severe infections are less effective, especially if the fungus has already caused widespread health problems. Patients generally need to receive frequent checkups and take daily medications in an effort to reduce the chance of recurring complications.