What Is Fungal Sinusitis, and Are Its Snotty Symptoms Treatable?

Feeling a little stuffy, sneezy, and congested? If you’ve been sick for several weeks, you might not be suffering from the common cold alone, you may actually have fungal sinusitis.

Sinusitis describes a condition where some form of invader (typically, a bacteria or virus) colonizes the nasal cavities. This, in turn, causes the sufferer to experience:

• • Congestion
  • Excess mucus build-up
  • Pain
  • Headaches
  • Sometimes, even a low-grade fever

These are all signs the body is trying to fight the troublesome germs off. Occasionally, the invader in question is neither bacteria nor virus; it is a fungus instead. This is referred to as fungal sinusitis, and it can be much more difficult to treat. Here’s what you need to know about it to stay – or get – well.

What Exactly Is Fungal Sinusitis?

Fungal sinusitis isn’t a single condition; instead, it refers to any fungal infection of the nasal passages and/or sinus cavities. It causes symptoms that are very much indistinguishable from bacterial or viral sinusitis – stuffy nose, congestion, nasal or facial pain, headaches, and sometimes, low-grade fever.

The main difference between this and other forms of sinusitis is that fungal sinusitis carries a greater risk of very serious side effects. This includes:

• • Facial numbness
  • Nerve damage
  • Changes in the skin (including necrosis, or tissue death)

The good news is that these more severe side effects are still rare.

Sinusitis is also more likely to affect people who are already sick (such as with a bacterial sinus infection) and/or who are somehow immunocompromised. This may include infants, seniors, people undergoing chemotherapy, and people who are diagnosed with some form of immune disorder (like Diabetes or MS).

Types of Fungal Sinusitis

As mentioned previously, being immunocompromised or ill can increase your risk for opportunistic fungal infections. But there are a number of more precise explanations for what causes the disease itself and how it unfolds. Primarily, most fungal sinusitis cases fall into one of the following four categories.

1. Fungus Ball Sinusitis

This condition occurs when a fungal invasion becomes embedded, or “stuck” in the nasal cavity and/or sinuses. This often occurs as a side effect to an existing head cold or bacterial infection. As the volume of fungus present grows, it begins to accumulate, creating a small mass of material that can be difficult to dislodge. It is the most common type of the condition to affect otherwise healthy individuals.

Treating fungus ball sinusitis starts with either topical (e.g., nasal sprays) or oral antifungal medications. Surgery to remove the material is often required; however, some cases do resolve without it.

2. Invasive Fungal Sinusitis

This is the most serious, and the most complex, form of the condition. There are three distinct forms:

• • Chronic Invasive Sinusitis – Fungal invasion remains for a longer period of time, sometimes despite treatment. This leads to severe problems with the nasal cavities over time, but the condition progresses very slowly – often, too slow for the patient to notice small changes. It is far more common in immunocompromised patients.
  • Acute Fulminant Invasive Fungal Sinusitis – Fungus invades the nasal passages and sinuses, but attacks localized blood vessels instead. This condition can come on quickly and may be life-threatening due to the risk for septicemia and blood infections. It also carries a risk for permanent damage to tissue and/or loss of the nose.
  • Chronic Indolent/Granulomatous Sinusitis – The immune system correctly identifies a fungal invasion, but begins to attack the nasal passages and/or the patient’s own respiratory system instead of the fungus. The lining of the nose, including cartilage and bone, can be severely affected without treatment.

     

3. Allergic Fungal Sinusitis

Again, here, the patient’s own immune system detects a fungus and kicks itself too far into overdrive. It begins to attack localized tissues in an effort to eliminate the perceived threat, often causing disfigurement and/or distortion of the facial features. Sinuses may swell dramatically, and patients often notice other allergy symptoms.

In most cases, patients with allergic fungal sinusitis require manual drainage (e.g., surgery) of the sinuses as well as anti-fungal drugs. Some patients may need to take medications long-term to prevent re-infection.

4. Saprophytic Fungal Sinusitis

In saprophytic fungal sinusitis, fungus invades the nasal passages and sinuses, but grows on top of existing mucus (particularly dry, crusty buildup as one would have after a cold or infection). The nasal and/or sinus lining isn’t usually affected; however, saprophytic sinusitis may morph into another more serious form if left unaddressed for too long.

This is the easiest of all types to treat because removal generally only requires removal of the underlying crusts. If the infection occurs low enough in the nasal passages, it may even be possible to manually extract them with rinses, sprays, and/or simple tools found at your doctor’s office.

How to Prevent Sinusitis

The world we live in contains tiny fungi most of us can’t even see – including the types that cause this condition. Thus, there is no foolproof way to avoid the risk of infection entirely. But that doesn’t mean there isn’t anything you can do at all.

First, if you are immunocompromised, seek treatment and support with managing your illness or disease. By limiting how it affects your ability to fight off infection, you will also improve your ability to fight off fungal sinusitis:

1. 1. Take any prescribed medications as directed
   2. Connect with your doctor about any changes in your condition
   3. Do your best to eat healthy, exercise, and get enough sleep.

Because fungal spores tend to breed in moist, dark environments, it is possible that being around these zones may raise your risk for fungal sinusitis. This is especially true if you have a condition like HIV/AIDS, cancer, or are on chemotherapy. Keep bathrooms dry and be on the lookout for mold – it is both a fungus in its own right and a sign that humidity or moisture levels are ideal for infestations.

Tell your doctor immediately if any common cold or flu seems to “settle” in your sinuses or doesn’t go away within three to four days. This may be a sign of a fungal infection taking hold. Your doctor may choose to treat you prophylactically (“just in case”) with anti-fungal drugs.

Consider using a neti pot or nasal rinse to flush out nasal passages if you experience dryness, crusting, or congestion. This can help break up mucus and remove the environment fungal sinusitis thrives in.

This condition can be prevented and treated, but it’s important to be familiar with it to reduce your risk of serious problems. Still have more questions? Contact your pharmacy or doctor today.

Frequently Asked Questions