Allergic fungal sinusitis is the most common fungal infection, but invasive and chronic are much more serious. The symptoms of all three mimic those of bacterial sinusitis. And because fungal sinusitis can cause destruction of bone, and even be fatal, its diagnosis is extremely important.
Sinusitis is the inflammation of any sinus membrane. It can be viral, bacterial, or, less commonly, fungal. Viral sinusitis often accompanies an upper respiratory infection. If drainage doesn't occur, bacteria may be trapped in the sinuses, leading to bacterial sinusitis. Fungal sinusitis is caused by fungi common in the environment and has symptoms similar to those of bacterial.
Common sinusitis symptoms include thick, yellow or green mucous and a stuffy nose. Less commonly, there may be a sore throat, foul breath, tiredness and a weakened sense of smell. You may also have post nasal drip, ear pressure or a toothache. Headache is the most common symptom of sinusitis, however. Fever, swelling of the face, and increased pain are symptoms of bacterial and fungal sinusitis.
Usually, when fungus is present, nasal polyps and thick secretions are too. According to the American Rhinologic Society, x-rays of those with fungal sinusitis show blockage of the sinuses and can show significant thinning of bone mass as well. Fungal sinusitis can be one of three types: allergic, invasive and chronic.
Invasive Fungal Sinusitis
The least common, and most serious, of the fungal sinus infections is invasive fungal sinusitis. As the name implies, it grows quickly and invades the sinus tissues and bones. Those diagnosed with it usually have a weakened immune system, possibly from uncontrolled diabetes or chemotherapy, the Rhinologic Society states.
Chronic Fungal Sinusitis
Chronic fungal sinusitis moves more slowly than invasive, but has the same path of destruction. It grows into the sinus tissues and bones, as well. However, most patients with chronic fungal sinusitis have a normal immune system. Alhough its symptoms, like other fungal sinusitis, mimic those of bacterial sinus infections, mold spores and dying tissue are evident upon examination.
Allergic Fungal Sinusitis
Allergic fungal sinusitis results when fungi cause nasal passages to react by swelling and becoming congested. It is also characterized by nasal and sinus polyps. Chronic inflammation results when these polyps block the nasal and sinus passages.
Diagnosis and Treatment
Although sinusitis symptoms can mimic those of a cold, longevity is a good indicator that a sinus is infected. A physician can diagnose one by noting symptoms and examining the nasal passages and tissues. If the diagnoses isn't clear-cut, the doctor can order a computed tomography, or CT scan. The doctor can exclude possibilities by testing nasal secretions for bacterial or fungal infections, ordering a blood or sweat test to check for cystic fibrosis, or by taking a biopsy of nasal membranes. Doctors use surgery and anti-fungal medications, plus anti-inflammation drugs, to treat fungal sinusitis. Treatment is essential in the case of invasive and chronic types as the infection can go far beyond the nose and sinuses. In some cases, it is fatal. In fact, invasive fungal sinusitis has a high mortality rate.