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Fungal Rhinosinusitis: Treatment, symptoms, advice and help

About fungal rhinosinusitis

Fungal rhinosinusitis is characterised by inflammation of the nasal passages and sinuses. This is caused by infection by a kind of fungi which are plant like micro-organisms. All the sinuses may get involved including frontal, ethmoid and maxillary.

Fungal rhinosinusitis: Incidence, age and sex

Fungal rhinosinusitis has been a rarely encountered disease in the general population. However, its incidence is on the rise in recent times. It may affect an individual of any age group. However, it is more frequently seen in older adults with the same prevalence in both men and women.

Signs and symptoms of fungal rhinosinusitis: Diagnosis

The clinical features of fungal rhinosinusitis include persistent nasal discharge which may be black or blood-stained. The affected individual may experience nasal blockage resulting in difficulty in breathing. Sometimes, the infection may be severe enough to cause fever, headache and intense facial pain. Maxillary sinuses are most commonly affected leading to tenderness over the cheeks. Occasionally, the sinus may get filled with fungal debris, which is called ‘fungal ball’. This fungal ball may be yellow or black in colour depending upon the fungus involved.

A detailed physical examination by a specialist is mandatory to detect this condition. Imaging of suspected sinuses by the CT scan may reveal their pathological condition. A sample of nasal discharge can be cultured and examined microscopically to reveal the offending fungus.

Causes and prevention of fungal rhinosinusitis

Fungal rhinosinusitis is caused by fungi, most common of which are Aspergillus and Mucor. Such fungal infections are commonly encountered in individuals whose immune system is suppressed like HIV patients or diabetics. Individuals who are on chemotherapeutic medications are also prone to fungal rhinosinusitis.

Fungal rhinosinusitis: Complications

Fungal rhinosinusitis has a high recurrence rate. An individual infected with fungal rhinosinusitis may be prone for repeated episodes of similar infection in future. Occasionally, this rhinosinusitis may invade the eye tissue causing vision impairment. The fungal infection may also spread to the coverings of the brain resulting in meningitis which is a potentially fatal condition.

Fungal rhinosinusitis: Treatment

The treatment modalities for fungal rhinosinusitis include medications as well as surgical procedure. Anti-fungal drugs usually are not of much value in treating this rhinosinusitis. But steroidal nasal sprays have shown benefit in many individuals. Sometimes, sinus lavage may be helpful in symptomatic relief. Antipyretic and analgesic drugs are prescribed to individuals with fever and pain. Long-standing cases may need surgical intervention wherein the fungal ball and dead tissue is surgically removed from sinuses or nasal passage. The prognosis is good and the individual recovers completely, if fungal rhinosinusitis has not invaded other tissues.