Invasive fungal sinusitis is a deadly disease carrying a 50 percent mortality rate.
Even though fungus is usually present to a greater or lesser extent in most patients suffering from long-term, or "chronic Sinusitis," the cause of repetitive sinus attacks is largely unknown.
However, since most diabetics and asthmatics who suffer from chronic sinusitis also have allergies and are susceptible to fungus invasion, researchers believe that the two conditions are linked.
If so, many people who present symptoms of chronic sinusitis may in fact be suffering from allergic fungal sinusitis – or its deadlier invasive counterpart.
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The deadly invasive type can be broken down into two sub-groups
As mentioned, although this disease is extremely rare, the chances of survival are less than 50 percent.
With acute invasive fungal sinusitis, the fungus grows into the tissues lining the sinus cavities and then into the bone itself.
Onset is rapid.
Bone, tissue and even the brain are affected within hours or days.
The symptoms are as follows:
o Fever
o Facial pain or numbness
o Facial swelling
o Hacking cough
o Prolific nasal discharge
o Severe headache
o Delerium followed by mental status changes
o Dark ulcers within the nasal canal or on the roof of the mouth
o Visual disturbances
For the patient to stand a chance of surviving this disease, the symptoms must be recognized early and treated aggressively.
Extensive surgical debridement is essential; every particle of infected tissue and bone must be removed. This is followed by ongoing intravenous anti-fungal treatment until the patient is out of danger.
Acute invasive fungal sinusitis normally manifests in diabetics suffering from a serious complication known as “diabetic ketoacidosis;” immunocompromised people are also at risk.
This is a slowly progressive fungal infection that can manifest over months.
This illness also occurs in immunocompromised patients and diabetics.
Unfortunately the fungus is opaque to MRI examination. However, the disease also presents symptoms of something called "Orbital Apex Syndrome." This causes optical problems accompanied by deformity of the eye sockets.
This is readily recognizable, because in many cases one eye appears to be higher than the other. Vision problems and ocular immobility are common.
Treatment with antifungal drugs and surgical removal of the infected tissue is mandatory. A prolonged course of systemic antifungals is required in order to prevent recurrence.
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In this disease fungus does not invade tissue or bone, it merely colonizes the nasal passages and sinuses.
In addition, nasal polyps form an anchor for the fungi, thereby encouraging growth.
This promotes the formation of partially calcified masses known as "fungus balls." These growths further obstruct the sinuses, leading to bacterial infection followed by an acute sinusitis attack.
Surgical removal of both polyps and fungus balls is essential.
Once the obstruction is removed, no further treatment is necessary.
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