We all inhale fungal spores every day and these are usually trapped in the mucous and cleared not resulting in any sequelae. However, there are times when sinusitis is caused and this can be divided into two groups, the invasive and the non-invasive form. 

In the non-invasive form the first one is when fungus grows on, for instance, dry mucous and causes nose symptoms.  The treatment of this is to remove the crusting and use Saline nose douche.  The second non-invasive sinusitis is called a fungal ball and this usually found in older females who have had dental work and the fungus grows on, for instance, the dental amalgam in the cheek sinus maxilla.  This may produce cheek sinus symptoms and is usually removed through the nose by widening the normal hole from the maxilla.  The third non-invasive form of fungal sinusitis is called AFRS and this stands for Allergic Fungal Rhinosinusitis.  I will discuss this in my next blog.

The invasive forms of fungal disease are rare and associated with decreased immunity such as HIV disease and diabetes.  This is when the fungus invades the blood vessels resulting in dead tissue.  The fatality rate is high at about 50% with spread of the disease to the eyes and brain.  Surgery is indicated with wide removal of the diseased tissue and intravenous anti-fungals.