Fungal Infections Of Sinuses
Fungal infections of sinuses are the main culprits for chronic rhinosinusitis. This is of course a recent finding in the field of science. In most cases the fungal infections of the sinuses are non invasive type. Invasive type fungal infection is possible in case of immune suppressed individuals. .
Differentiating the non invasive type from the invasive type is very essential as the treatment and the prognosis are not the same for the both types. The invasive fungal infection of the sinuses has three different forms or types and the noninvasive type has two different forms.
Fungal Infections of Sinuses- Causes
The two forms of noninvasive fungal infection of sinuses are sinus mycetoma and allergic fungal sinusitis. The species that bring about sinus mycetoma infection are bipolaris, aspergillus fumigates, curvularia lunata. The allergic fungal infection is caused by drechslera species.
Acute invasive sinusitis [fungal] is caused by rhisopus, mucor, rhinomucor, absidia, mortirella, and saksenaea. All these are saprophytic type of fungi. Chronic invasive sinusitis [fungal] is caused by aspergillus fumigatus. Granulomatus invasive sinusitis [fungal] is caused by aspergillus flavus.
Treatment of Fungal Infections of Sinuses
Surgical treatments are the best for all type of fungal infection of sinuses but the medical therapy is also effective. The medical therapy depends on invasiveness and the type of infection present.
Allergic fungal sinusitis
The surgery is the best option. Steroids can be tried to reduce the inflammation once the diagnosis is confirmed as well as after the surgery. Topical application of the steroids also can be tried. Nasal wash with salt water cam also be attempted. Systemic antifungal therapy can be advocated in case invasiveness is not present.
Surgical removal of the fungal ball is the only option left. There is no need for antifungal therapy even once the fungal ball is removed. Anti inflammatory drugs can be administered.
Chronic invasive sinusitis [fungal]
The surgical therapy is the ultimate option. But systemic antifungal therapy can be tried once the diagnosis is confirmed. Ketoconazole and amphotericin B are considered to be very effective.
Acute invasive sinusitis [fungal]
Try to go for surgery as early as possible. Systemic antifungal treatment is advised after the surgery. Amphotericin B is the drug of choice. We can switch over to oral itraconazole as soon as the acute stage is over. Try to improve the immune status of the body, if that found to be the root cause.
Chronic granulomatous sinusitis [fungal]
Once again for this kind of fungal infection of the sinuses, the surgical treatment is the best as far as quick relief is concerned. Systemic antifungal treatment must follow the surgery. As far as reoccurrence is concerned, it is very rare.
Acute infection – severe infection that needs treatment at once. Chronic infection – mild but prolonged infection.