Most common cause of fungal sinusits ?
Correct Answer: Aspergillus fumigatus
Description: Ans. is 'a' i.e., Aspergillus fumigatus Fungal sinusitis The sinuses are moist dark cavities and are a natural home to the invading fungi. When this occurs, fungal sinusitis results. Most common fungal infection of paranasal sinus is Aspergillus (A fumigatus > A niger > A flavus). Other offending fungi are Alternaria, Mucor and Rhizopus. Types of fungal sinusitis There are four types of fungal sinusitis :? 1. Mycetoma fungal sinusitis (fungal ball) :- Produces clumps of spores, a "fungal ball", within a sinus cavity, most frequently in maxillary sinus. The patient maintains an effective immune system. The non-invasive nature of this disorder requires a treatment consisting of simple scraping of infected sinus. An anti fungal therapy is generally not prescribed. 2. Allergic fungal sinusitis (AFS) :- It is a non-invasive condition which is believed to be an allergic reaction to the environmental fungi that is finely dispersed into the air. Patient is usually immunocompetent with normal immune system. Treatment consists of endoscopic surgical clearance of the sinus along with pre-and postoperative systemic steroids. Anti-inflammatory medical therapy and immunotherapy are typically prescribed to prevent recurrence. 3. Chronic indolent invasive sinusitis :- It is an invasive form of fungal sinusitis in immunocompetant patients. This is characterized by a granulomatous inflammatory infiltrates. Treatment consists of surgical removal of the involved mucosa, bone and soft tissue followed by iv amphotericin B. 4. Acute fulminant sinusitis :- It is usually seen in the immunocompromized patients. This disease leads to progressive destruction of the sinuses and can invade the bony cavities containing the eyeball and brain. Treatment is similar as for chronic indolent invasive sinusitis i.e. surgical removal followed by systemic antifungal.
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