The incidence of fungal
infections is increasing. Funguses involved in sinusitis are the
Curvularia, Bipolaris, Exserohilum, and Mucormycosis
The fungus Aspergillus
is the most common cause of all forms of fungal sinusitis.
There have been a few
reports of fungal sinusitis caused by Metarrhizium anisopliae ,
which is used in biological insect control.
There are four categories
of fungal sinusitis:
- Acute or invasive fungal sinusitis.
This infection is most likely to affect people with diabetes and
compromised immune systems.
- Chronic or indolent fungal sinusitis.
This form is generally found outside the US, most commonly in
the Sudan and northern India.
- Fungus ball (mycetoma). This
fungal sinusitis is noninvasive and occurs usually in one sinus,
most often the maxillary sinus.
- Allergic fungal sinusitis.
This form typically occurs because of an allergy to the fungus
Aspergillus (rather than being caused by the fungus itself). In
such cases, a peanut butter-like fungal growth occurs in the sinus
cavities that may cause nasal passage obstruction and the erosion
of the bones.
Fungal infections can
be very serious, and both chronic and acute fungal sinusitis require
immediate treatment. Fungal ball is not invasive and is nearly always
Fungal infections should
be suspected in people with sinusitis who also have diabetes, leukemia,
AIDS, or other conditions that impair the immune system. Fungal
infections can also occur in patients with healthy immune systems
but they are far less common.