Fungal sinusitis clinical presentation, latest management: A Review Update

Fungal sinusitis is a relatively common, often misdiagnosed disease process involving the paranasal sinuses. It is a serious condition, as certain forms of fungal sinusitis are associated with a high rate of mortality. Successful treatment requires a prompt diagnosis and frequently relies on radiologic imaging, specifically computed tomography (CT) and magnetic resonance (MR) imaging. The classification of fungal sinusitis is ever changing, but under the most current and widely accepted classification fungal sinusitis is broadly categorized as either invasive or noninvasive. Invasive fungal sinusitis is defined by the presence of fungal hyphae within the mucosa, submucosa, bone, or blood vessels of the paranasal sinuses. Invasive fungal sinusitis is subdivided into acute invasive fungal sinusitis, chronic invasive fungal sinusitis, and chronic granulomatous invasive fungal sinusitis. Conversely, noninvasive fungal sinusitis is defined by the absence of hyphae within the mucosal and other tissues of the paranasal sinuses. Noninvasive fungal sinusitis is subdivided into allergic fungal sinusitis and fungus ball (fungal mycetoma).Journal of Science Foundation, 2014;12(1):16-19

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Invasive Fungal Sinusitis

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1123 ◽

2012 ◽

Vol 5 (2) ◽

pp. 63-71 ◽

Cited By ~ 5

Author(s):

Rijuneeta LNU ◽

Bhumika Gupta

Keyword(s):

Hematologic Malignancy ◽

Interdisciplinary Approach ◽

North India ◽

Fungal Sinusitis ◽

Allergic Fungal Sinusitis ◽

Early Management ◽

Invasive Fungal Sinusitis ◽

The Family ◽

Fungus Balls ◽

Chronic Invasive

ABSTRACT Invasive sinus Aspergillus infection has been reported in the last decade with increased frequency, most commonly in the setting of hematologic malignancy, neutropenia, HIV infection and other states of immunosuppression. Fungal rhinosinusitis can be broadly classified into two varieties-invasive and noninvasive on the basis of tissue invasion. Invasive fungal sinusitis are acute invasive, chronic invasive (both granulomatous and nongranulomatous forms), whereas noninvasive are fungus balls and allergic fungal sinusitis. Invasive fungal sinusitis is one of the most challenging forms of sinonasal pathology to manage, most commonly presenting in immunocompromised individuals. Chronic invasive being sinus aspergillosis (CISA) is being reported in immunocompetent patients at an increasing rate while most of these cases are being reported from the India subcontinent and middle east. Invasive fungal sinusitis is on the rise worldwide and especially in north India as it is endemic in this part of the country. It is affecting immunocompetent young and middle aged population causing a great morbidity and mortality. This entity needs to be picked up early by spreading awareness among the family physicians, internists, otolaryngologists, ophthalmologists, neurosurgeons, pulmonary physicians, critical care specialists so that an early management can initiated to achieve better control over the disease. This review is an attempt to initiate an interdisciplinary approach to achieve a better outcome. How to cite this article Gupta AK, Bansal S, Rijuneeta, Gupta B. Invasive Fungal Sinusitis. Clin Rhinol An Int J 2012;5(2): 63-71.

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Conversion to Chronic Invasive Fungal Sinusitis From Allergic Fungal Sinusitis in Immunocompetence

The Laryngoscope ◽

10.1002/lary.27884 ◽

2019 ◽

Vol 129 (11) ◽

pp. 2447-2450 ◽

Cited By ~ 6

Author(s):

Luke Edelmayer ◽

Christopher Ito ◽

Won Sok Lee ◽

James Kimbrough ◽

Stilianos E. Kountakis ◽

...

Keyword(s):

Fungal Sinusitis ◽

Allergic Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Chronic Invasive

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Imaging of granulomatous and chronic invasive fungal sinusitis: Comparison with allergic fungal sinusitis

Otolaryngology ◽

10.1016/j.otohns.2010.02.027 ◽

2010 ◽

Vol 143 (2) ◽

pp. 294-300 ◽

Cited By ~ 28

Author(s):

C. Ekambar Eshwara Reddy ◽

Ashok K. Gupta ◽

Paramjit Singh ◽

Sher B. S. Mann

Keyword(s):

Fungal Sinusitis ◽

Allergic Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Chronic Invasive

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Chronic Invasive Fungal Sinusitis With Negative Histopathology: A Diagnostic Challenge

Ear Nose & Throat Journal ◽

10.1177/0145561320973773 ◽

2021 ◽

pp. 014556132097377

Author(s):

Anne Ning ◽

Arminé Kocharyan ◽

W Colby Brown ◽

Brian D’Anza

Keyword(s):

Definitive Diagnosis ◽

Fungal Sinusitis ◽

Chain Reaction ◽

Diagnostic Challenge ◽

Invasive Fungal Sinusitis ◽

Fungal Organisms ◽

Fungal Dna ◽

Polymerase Chain ◽

Histopathologic Findings ◽

Chronic Invasive

Although the diagnosis of chronic invasive fungal sinusitis relies chiefly on identification of invasive fungi on histology, the insidious nature of the disease can preclude detection of fungal organisms. Here, we present a case of chronic invasive fungal sinusitis with negative histopathologic findings and a definitive diagnosis made through fungal DNA detection. Clinicians should consider polymerase chain reaction an important complement to histology and culture in the diagnosis of chronic invasive fungal sinusitis.

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A Case of Chronic Invasive Fungal Sinusitis with Invasion of the Nasolacrimal Duct

Practica oto-rhino-laryngologica Suppl ◽

10.5631/jibirinsuppl.148.40 ◽

2017 ◽

Vol 148 (0) ◽

pp. 40-41

Author(s):

Shuta Tomisato ◽

Sayuri Yamamoto ◽

Taiji Kawasaki ◽

Koichirou Wasano

Keyword(s):

Nasolacrimal Duct ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Chronic Invasive

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Paranasal Sinuses Fungal Balls in Children

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1059 ◽

2010 ◽

Vol 3 (3) ◽

pp. 181-183

Author(s):

Sunita Agarwal

Keyword(s):

Case Report ◽

Young Children ◽

Ct Scan ◽

Paranasal Sinuses ◽

Histopathological Examination ◽

Fungal Sinusitis ◽

Provisional Diagnosis ◽

Invasive Fungal Sinusitis ◽

First Case ◽

Rule Out

Abstract Objective Rare cases of fungal balls of paranasal sinuses in children. No case has been reported in young children so far. However, allergic aspergillosis has been reported in young children. Method A case report of 2 cases of fungal balls of paranasal sinuses in children and review of the current literature concerning fungal balls of paranasal sinuses in children are presented. Result 2 cases of fungal balls in paranasal sinuses were diagnosed in children of 9 and 10 years respectively. Both of them presented with nasal obstruction and eye signs provisional diagnosis was based on CT scan findings. FESS was done and fungal balls were subjected to histopathological examination to rule out invasive fungal sinusitis, fungal staining and culture were done which confirmed the diagnosis of Aspergillosis. Conclusion To our knowledge this is the first case report of fungal balls in PNS in children in otolaryngology literature. Both the patients were males with age of 9 and 10 years respectively.

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Chronic Invasive Fungal Sinusitis Presenting as Inferior Altitudinal Visual Field Defect

Neuro-Ophthalmology ◽

10.1080/01658107.2017.1292296 ◽

2017 ◽

Vol 41 (3) ◽

pp. 144-148

Author(s):

Reema Bansal ◽

Aastha Takkar ◽

Vivek Lal ◽

Amanjit Bal ◽

Sandeep Bansal

Keyword(s):

Visual Field ◽

Visual Field Defect ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Field Defect ◽

Chronic Invasive

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The clinicopathological and radiological features of unilateral nasal mass in adults, a tertiary hospital experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202772 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1226

Author(s):

Hadeel M. Aljafar ◽

Eman R. Alenazi ◽

Abdulrahman M. Alkhatib ◽

Ghaleb M. Alazzeh ◽

Ali A. Almomen

Keyword(s):

Clinical Diagnosis ◽

Histological Finding ◽

Surgical Excision ◽

High Rate ◽

Fungal Sinusitis ◽

Radiological Findings ◽

Tertiary Referral Hospital ◽

Allergic Fungal Sinusitis ◽

Nasal Mass ◽

Sinonasal Mass

Background: Aim and objectives of the study were to analyze and study the diverse presentations of unilateral nasal mass and to identify the suggestive features of neoplastic pathology in adult’s population at a tertiary referral hospital.Methods: A retrospective analysis of 90 patients presented with unilateral sinonasal mass, reported to the Rhinology and Skull Base Clinic at the department of ENT in King Fahad Specialist Hospital, Dammam. The parameters include patient history, clinical assessments and histopathological examinations, which were supplemented with radiological investigations.In addition, demographic information and histopathological examinations for patients, who underwent surgical excision was analyzed for correlation with clinical diagnosis. Results: The reported cases are 55 males and 35 females with a median follow-up period of 12 months, ranging from 2-72 months. Nasal obstruction is the major symptom 34 (38%), 25 (27.8%) cases were reported with nasal mass and clinical diagnosis indicates 18 (20%) cases of malignancy. Type of disease and gender demonstrates low significance (p=0.023), whereas the diagnosis with age is highly significant (p=0.005).Conclusions: Carcinoma, inflammatory polyposis, inverted papilloma and allergic fungal sinusitis were the highest histological diagnosis. The clinical diagnosis and the suggestive features of radiological findings mostly resembled the histological findings. In contrary to the resemblance, the histological finding reveals the general diagnosis of nasal mass to the precise diagnosis, especially the fatal conditions like carcinoma. The high rate of malignancy and its suggestive radiological findings indicates that the specialists should consider the cases with caution to carryout histological analysis to rule out the probability of neoplasm.

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Fungal sinusitis diagnostic management and classification

Acta chirurgica iugoslavica ◽

10.2298/aci0903145p ◽

2009 ◽

Vol 56 (3) ◽

pp. 145-148

Author(s):

I. Pendjer ◽

I. Boricic ◽

V. Arsic ◽

Z. Dudvarski ◽

J. Dotlic ◽

...

Keyword(s):

Elevated Serum ◽

Diagnostic Procedures ◽

Specific Ige ◽

Topical Steroids ◽

Positive Staining ◽

Fungal Sinusitis ◽

Allergic Fungal Sinusitis ◽

Positive Skin ◽

Non Invasive ◽

Invasive Fungal Sinusitis

The aim of this paper is to present the current classification of fungal sinusitis and share our experiences in diagnostic procedures and treatment outcomes. The study includes 31 patients operated since 2000-2009. in whome some form of fungal infection had been diagnosed. There were 10 patients with mycetoma, and 16 patients with chronic non-invasive fungal sinusitis, while in five patients allergic fungal sinusitis was proven. All patients were treated postoperatively with topical steroids and irrigation with saline solution, without use of fungicides. Characteristics of chronic non-invasive funga sinusitis and mycetoma are CT with specific opacification and calcification with involement of maxillary sinus unilaterally or bilateral together with pathohistological finding of positive staining by Grocott with the identification of fungi from secret or tissue. Allergic fungal sinusitis is characterized by eosinophilia, positive skin test to fungal allergens, elevated serum level of both specific IgE antibodies to causal fungus and total IgE, as well as, pathohistological finding of allergic mucus which include non-invasive hifa. Fungal sinusitis in immunocompetent patients is classified into the following categories: mycetoma, chronic non-invasive fungal sinusitis, chronic indolent sinusitis (which does not occur in our population) and allergic fungal sinusitis.

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A clinicopathological study of the lesions of paranasal sinuses causing proptosis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202773 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1238

Author(s):

Vineeth Abraham Anchery ◽

Viswanathan Kavathur

Keyword(s):

Paranasal Sinuses ◽

Disease Process ◽

Underlying Disease ◽

Fungal Sinusitis ◽

Nasal Sinus ◽

Sinus Disease ◽

Duration Of Illness ◽

Male Preponderance ◽

Malignant Lesions ◽

Benign Tumours

Background: The orbit and its contents lie in close proximity to the paranasal sinuses. The aim of the study was to analyse the lesions of paranasal sinuses causing proptosis.Methods: All patients with proptosis secondary to paranasal sinus disease were taken up for a systematic otolaryngological and ophthalmological clinical evaluation and investigation using a standard proforma. Incidence of various disease of paranasal sinuses causing proptosis, age and sex distribution, incidence of different symptoms and signs and its association with proptosis were estimated. The reversible and irreversible nature of the proptosis in relation to the degree of proptosis and the histopathological nature of the disease were studied. Results: Malignant diseases were found to be the commonest lesion that caused proptosis. Squamous cell carcinoma was the most common histopathological type. Invasive fungal sinusitis among inflammatory and inverted papilloma among benign tumours were the commonest lesions that cause proptosis. Male preponderance was seen in the inflammatory and malignant lesions and the commonest symptoms were headache and nasal obstruction. Malignancies caused faster proptosis than benign and inflammatory lesions. Analysis of X-ray and computed tomography (CT) findings were also done.Conclusions: Malignant lesions are the most common para nasal sinus disease that cause proptosis. Duration of illness and degree of proptosis varied with the underlying disease process. With inflammatory proptosis some underlying sinus pathology in addition to the sinusitis is found in all cases. CT is a better modality to identify underlying pathology.

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