Fungal Sinusitis Q&A

Q: Is Fungal Sinusitis Common?rnA: The fungi that cause fungal sinusitis include the most common varieties of fungi we know, such as the common bread molds. Furthermore, these fungal elements are found almost anywhere - in the soil and even in the air we breathe. Quite surprisingly though, there are more diagnosed cases of bacterial, compared to fungal sinusitis, especially when considering the acute cases (acute means the onset of manifestations is sudden or abrupt). The reason for this is that most people with a healthy immune system can tolerate fungi. Minimal exposure to offending fungi would normally not trigger an inflammatory response. Only certain people, because of their underlying medical conditions are at greater risk for fungal sinusitis. This group includes those who have hypersensitivity (allergic) reaction to the causative mold; those with prolonged exposure to an environment contaminated with fungi; and finally, those patients which have a weakened immune system like those who have diabetes, cancer or AIDS. Q: How Do You Know It’s Fungal Sinusitis?rnA: The general manifestations of fungal sinusitis are in fact, similar to bacterial sinusitis. However, a visit to your trusted health practitioner can help work-out a differential diagnosis. Your doctor will probably ask you some questions in order to come up with a medical history. A history of exposure to fungal elements; repetitive bouts with sinusitis; and unresponsiveness to antibiotic therapy provide important cues that it could be a case of fungal sinusitis. The doctor can also order for diagnostic tests like a nasal or throat swab for culture; and imaging tests like x-ray or CT-scan to visualize the paranasal sinuses and nearby structures. Imaging studies are also useful in identifying the case of fungal sinusitis as to its specific type - whether fungal ball, allergic fungal sinusitis, acute or chronic invasive fugal sinusitis. Q: What’s the Treatment Plan?rnA: The treatment plan for fungal sinusitis is unfortunately one that could be very frustrating for the patient and even for a doctor because it is usually long term and takes a great deal of patient compliance in order to be effective. The thing here is fungi are very resistant organisms. Just like in cases of fungal diseases of the skin or nails, the fungi must be totally eliminated. Otherwise, exposure to an environment which is conducive for the growth of fungi would easily result into a re-infection. In the case of fungal sinusitis, treatment with decongestants and nasal corticosteroids to abate the swelling of the sinuses and nasal passages and decrease the mucus secretion remains to be an important part of the regimen. Antibacterials, however, are not normally given to treat fungal sinusitis, unless there is a cross or mix infection. Agents that act against fungi, known as anti-mycotics or simply anti-fungals are prescribed. Anti-fungals are quite expensive and therefore must be taken strictly as prescribed. As a last resort, especially in cases of invasive fungal sinusitis, sinus surgery can be performed to correct the anatomic damage and to remove the fungal elements. Sinus Dynamics, a leading pharmaceutical company, has its complete line of medications for bacterial and fungal sinusitis and even allergic rhinitis. They also manufacture highly efficient nebulizers and medicated irrigators to facilitate quick and easy treatment.