Fungal Sinusitis: Causes and Treatment

Fungi are organisms which are akin to plants, although they cannot be accurately identified as plants because they lack chlorophyll in their makeup, and therefore are unable to manufacture their food. Fungi must rely on other dead organic matter for nourishment, and in some cases, they will even feed on living organisms as well. Fungi are present virtually everywhere, although they are not visible to the naked eye, and are otherwise undetectable. They can enter the human body through breathing, although in the vast majority of cases they are harmless. The fungi cannot cause any real harm because a healthy immune system immediately attacks them and prevents any further damage. However, in a compromised immune system, inflammation can occur around the nose and the sinuses, where conditions are naturally favorable for fungi to take up residence and thrive. Once they become entrenched there, with no serious opposition from the immune system, they can cause fungal sinusitis. The most frequently occurring variety of fungal sinusitis is allergic fungal sinusitis or AFS, and this strain develops in people who are allergic to some kinds of fungi.

Causes of Allergic Fungal Sinusitis

When fungi enter the human body through normal respiratory processes, there is an immediate immune reaction which automatically tries to prevent their establishment and proliferation. This triggers an allergic reaction and causes the sinuses to become swollen. When sinuses become swollen, it blocks passageways and creates an ideal environment for fungal growth, with all the natural moisture and warmth available in the nose.

People who have healthy immune systems will only experience AFS as a mild disease and will sustain the inconvenience of symptoms like a runny nose or nasal congestion. A weakened immune system can cause extreme facial pain, powerful headaches, a persistent cough, and uncomfortable swelling. Hearing problems can also develop if the ear canals become blocked by swelling, and this may cause extreme sensitivity to some sounds.

Many sufferers of AFS also experience bad breath because of the fungal growth which persists in their systems. Lung problems can develop as a result of nasal mucus dripping into the lungs and accumulating there. In the most extreme cases of AFS, sinuses and the bony part of the nose can be so expanded because of the disease, that they have the effect of forcing the eyes forward in the skull, causing a noticeable increase in the distance between the eyes.

A man holds his nose in pain from fungal sinusitis, surrounded by used tissues.

Fungal sinusitis is unique in that it is caused by exactly what it sounds like, fungi. Eliminating fungal growth is the key to treating symptoms of swelling, facial pain, and postnasal drip associated with this type of sinusitis.

Diagnosis of AFS

It’s essential to diagnose fungal sinusitis early on, so patients can avoid the more severe symptoms, and restore proper ear, nose, and lung health. One of the first diagnostic tests that a physician might perform is a blood test, which will indicate whether or not antibody levels have increased, showing that the immune system is on the alert.
CT scans and x-rays can be taken to check for the possibility of mucus in the sinus, as well as checking for the presence of the fungus itself. Skin tests are often used to determine whether or not a patient is allergic to specific fungi, which will increase the degree of any symptoms experienced. Local minor surgery can also be used as a treatment option, to precisely locate the mucus and extract a sample that can be tested for any fungal presence. If any of these diagnostic test results indicate fungal sinusitis, a treatment program will quickly be recommended and implemented.

Treatment of AFS

The primary objective of any AFS treatment program is to eliminate the buildup of mucus, and the fungi which triggered the allergic reaction. However, since the fungus may return, steps must also be taken to prevent its recurrence, generally making use of medications and in some cases surgery.

To remove the mucus layer and the fungi from a patient, a doctor will utilize a tube-like instrument which has been inserted with a camera. This tube must be inserted through the nostrils so that the mucus and fungi can be precisely located and removed.
Medications are also generally part of an ongoing treatment program. These can include steroids for the reduction of any inflammation, antifungal medications which prevent the growth of the fungus, antibiotics which are essential for managing bacterial infection, and quite often, inhalation sessions which work to relieve blockage and restore nasal passage flow.

Some of the more advanced techniques used for treating AFS include inoculating a patient with a tiny amount of inactive fungus, in much the same manner that flu shots include small amounts of the influenza virus. This triggers an immunotherapeutic response by working to build up the body’s natural resistance to fungus and theoretically preventing future invasions by the fungi.

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