What is allergic fungal sinusitis?
Allergic fungal sinusitis is a specific type of sinusitis that is caused by an allergy specific to the mold we breathe in the air. Unlike normal allergies, this condition allows the fungus to grow within the small confines of sinus and accumulate over a long period of time. A severe inflammatory reaction occurs causing nasal polyps to form, and allowing a thick glue-like mucous to build up and irritate the nasal lining. As the fungus continues to expand, it places large amounts of pressure along the walls of the sinuses which can cause the bone to be eroded. In severe cases, extensive bone destruction can allow the fungus to enter into the eye causing bulging (proptosis), or even protude into the skull, placing pressure on the brain directly. The disease is typically more severe in younger patients, as their immune system is stronger than older individuals.
![endoscopy-fungal-debris]()
Thick, green debris indicative of fungus within the nasal passage (red asterisk)
What causes allergic fungal sinusitis?
The most common cause for allergic fungal sinusitis is a fungus called Aspergillus, which is normally present in the air we breathe. In some people unfortunately, an extreme sensitivity to this fungus causes a cascade of inflammatory reactions resulting in severe, chronic sinusitis.
What are the symptoms for allergic fungal sinusitis?
MILD TO MODERATE DISEASE
- Nasal congestion
- Thick nasal discharge (yellow or green colored)
- Loss of smell
- Facial pain/pressure
MODERATE TO SEVERE DISEASE
All of the previous symptoms, plus:
- Eye bulging (proptosis)
- Headaches
- Changes in facial structure (widening eye distance)
![allergic-fungal-sinusitis-scan]()
Severe allergic fungal sinusitis causing pan-sinusitis (yellow dots). Fungus is seen eroding through the orbital bone, placing pressure onto the eyes (red arrows)
How do you treat allergic fungal sinusitis?
Although allergic fungal sinusitis is a benign condition, leaving it untreated may cause serious complications. Surgical treatment is always warranted initially in order to remove all the fungal debris trapped inside the sinuses. Although now all fungus is removed, the disease is still present. Because allergic fungal sinusitis is an allergy related condition, it will be up to the individual to ensure they continue using there sinus treatments as prescribed to prevent recurrence of the fungus. It may take several years of treatment for a patient to completely rid themselves of the fungal allergy.
