Fungal sinusitis occurs when fungi invade the sinuses, leading to infection and inflammation. Sinuses are air-filled cavities that produce mucus (nasal discharge) and drain properly to keep nasal passages clear, preventing germs and allergens from entering. Each type of fungal sinusitis presents with distinct symptoms.

Allergic fungal sinusitis

Allergic fungal sinusitis (AFS) is the most common type, resulting from an allergic reaction to various fungi, most frequently Aspergillus. Symptoms typically include nasal congestion, persistent sneezing, runny nose, and nasal redness. As the condition progresses, sinuses become blocked by thick mucus, gradually enlarging and causing eye and facial swelling.

Individuals with asthma or allergic rhinitis are more likely to develop AFS. This type of fungal sinusitis often requires surgery and ongoing monitoring to prevent recurrence.

Sinusitis often causes nasal congestion. Image created by AI.

Saprophytic fungal sinusitis

Saprophytic fungal sinusitis (SFS) is initially asymptomatic. Saprophytic fungi are organisms that thrive on dead or decaying organic matter. They secrete enzymes to break down organic material, then absorb it for sustenance. These fungi grow on mucosal crusts inside the nose. As the infection progresses, there is a high risk of invasion into nerves, blood vessels, and bone, leading to headache, facial pain, postnasal drip (mucus accumulating and draining down the back of the throat or out of the nose), and bulging eyes.

Fungi growing in the sinuses can form a fungal ball, also known as a mycetoma, which develops into a mass over time. Patients experience symptoms such as crusting inside the nose, facial pain, and postnasal drip (mucus from the sinuses and nasal passages draining into the throat). Fungal growth can obstruct sinuses, destroy blood vessels within the nose, causing tissue death. This creates conditions for rapid infection spread to the eyes and brain, potentially leading to blindness. This condition is more common in individuals with weakened immune systems, such as those with diabetes or cancer.

Untreated fungal sinusitis can easily lead to complications like a perforated eardrum and hearing loss, as the sinus infection can spread to the ear, causing otitis media (middle ear inflammation). Impact on the eyes can result in orbital inflammation, characterized by swelling, redness, pain, and reduced vision. Patients may also experience pharyngitis, tonsillitis, persistent cough, difficulty swallowing, pain, or abscess formation.

Patients should keep warm, avoid allergens, regularly clean nasal passages with saline solution, maintain a healthy lifestyle, and exercise consistently to help prevent sinusitis recurrence. Medical consultation is advised if symptoms worsen, causing facial numbness, eye and nose swelling, changes in skin color, frequent sinusitis episodes throughout the year, or a fever lasting 3-4 days accompanied by facial pain or pressure and a runny nose. Even mild symptoms persisting for more than 10 days without improvement warrant a medical check-up.

To diagnose fungal sinusitis, doctors conduct an examination, imaging tests, and a biopsy to obtain a small tissue sample. This sample is then examined under a microscope to confirm the presence of fungi.

Anh Chi (Source: Health)