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​Invasive Fungal Sinusitis (Fungal Sinus Infection)

What is Invasive Fungal Sinusitis?

There are two primary types of invasive fungal sinus infections, acute and chronic.

The acute version of fungal sinusitis is more serious and primarily occurs in people whose immune systems have been compromised. Fungi usually feed on dead organic matter, but weakened immune defenses can allow fungi to begin eating tissue that is still alive.

As the fungus reproduces, it spreads rapidly into the blood vessels, eye area, and central nervous system with devastating results. Acute invasive fungal sinusitis is a rare condition with a high mortality rate.

Fungal infection of the sinuses can occur when fungal organisms are inhaled and deposited in the nasal passageways and paranasal sinuses, causing inflammation. The dark, moist environment of the sinuses is ideal for fungi, which can reproduce without light or food.

Most fungal infections of the sinuses are noninvasive, meaning they won't spread to surrounding tissue.

Symptoms are similar to a sinus infection — congestion, facial pain and swelling, and discharge — but you may be severely ill with these symptoms.

At UPMC, the preferred surgical treatment for invasive fungal sinusitis is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. Benefits of EEA include:

  • No incisions to heal
  • No disfigurement
  • Faster recovery time

Diagnosing Invasive Fungal Sinusitis

Your physician will perform a physical exam and ask about any symptoms you have been having.

Symptoms of invasive fungal sinusitis

People with invasive fungal sinusitis usually are very ill, and may have some of the following symptoms:

  • Fever
  • Facial pain or numbness
  • Facial swelling
  • Cough
  • Nasal discharge
  • Headache
  • Mental status changes
  • Dark ulcers within the nasal canal or on the roof of the mouth
  • Visual disturbances

Symptoms of chronic invasive fungal sinusitis

Those with chronic invasive fungal sinusitis usually have symptoms of a long-standing sinus infection, including:

  • Congestion
  • Drainage
  • Pressure in the forehead, nose, and behind the eyes

Orbital apex syndrome is also characteristic of the chronic sinus infection. Its symptoms include decreased vision and ocular immobility, due to a mass of fungal material that has spread into the eye orbit.

Invasive Fungal Sinusitis Treatments

Acute invasive fungal sinusitis is a medical emergency, and surgery to remove the infected tissue should be performed immediately once the diagnosis is made. Radical removal of all dead and infected tissue is necessary. The chronic infection requires surgery as well.

Minimally invasive surgery

Tissue infected by invasive fungal sinusitis may be approached directly using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive treatment approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the infected tissue through the nose and nasal cavities.

EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.

Follow-up treatment

Treatment also includes follow-up with antifungal medications.

People with invasive fungal sinusitis need to remain under long-term observation by a doctor, as recurrence is common.


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