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Home   »   Conditions  »  Fungal Sinus Infection

The most common causes of sinus infections are linked to viral and bacterial infections. However, a fungal sinus infection differs in that it refers to an infection of any or all of the four paranasal sinuses caused by a fungal growth inside the body.

Fungi can be found both in nature, in your home and work environments, and in the air. Sometimes when fungal material or debris is inhaled into the nose and lungs, it may cause an infection. There are two forms of fungal sinus infections: invasive and non-invasive. Non-invasive infections do not spread anywhere besides the sinuses, and occur in patients who have normal immune systems. However, invasive fungal sinus infections can occur n in those patients whose immune systems are not as strong as the average person. An invasive sinus infection can become life-threatening in a very short amount of time, meaning that immediate treatment is critical.

Types Of Fungal Sinus Infection

Left: Non-Invasive Fungal Sinusitis as shown on a CT scan. Right: Treatment involves removal of fungal debris through functional endoscopic sinus surgery (FESS)

The most common type of fungal sinus infection is Allergic Fungal Rhinosinusitis (AFRS). This form is characterized by a chronic non-invasive sinus infection lasting over 12 weeks. Patients suffering from this condition often notice a thick, yellowish-brown mucus draining from the sinuses, and complain of severe nasal congestion, difficulty smelling, sinus pressure, and headaches. Many AFRS patients also report being asthmatic or having the sensitivity to aspirin.  AFRS suffers may also have nasal polyps. The five types of fungi that doctors cite as recurring causes of AFS include Cladosporium, Aspergillus, Alternaria, Curvularia, and Bipolaris.

Saline irrigations and anti-inflammatory medications are the mainstays of treatment for these patients. Endoscopic sinus surgery may be needed to rid the sinuses of nasal polyps and fungal material. The majority of patients report relief from surgery although for most the symptoms will return in some form.

The second form of a fungal sinus infection is Acute Fulminant Fungal Rhinosinusitis (AFFR). This type of sinus infection involves the invasion of fungal debris into the sinus tissues of an immunosuppressed patient. Most patients suffering from this form are either diabetic or have undergone chemotherapy radiation (two conditions that create immune suppression).  This form of fungal sinus infection is particularly harmful because of its ability to spread rapidly to the eye and brain, in addition to the vast amount of dead tissue that the fungus creates. Those diagnosed with AFFR require emergency surgery to remove the dead tissue and stop the fungus from spreading.

Left: As seen from the view of an endoscope, dead tissue and eschar are characteristic of AFFR. Right: Digital imaging scans shows the need for immediate surgery.

The third form of fungal sinus infection is a Chronic Invasive Fungal Rhinosinusitis (CIFR). Unlike AFFR, the spread of the fungus is not rapid but rather occurs over weeks or a succession of months. This form of sinus infection is fairly rare and affects those both with and without identifiable immune system disorders (i.e. diabetes, steroid-users). In addition to the normal symptoms of a fungal sinus infection, patients might also experience eye-swelling and decreased vision. Surgical evaluation is needed to remove the infected tissue. Post-operatively, patients may be encouraged to use anti-inflammatory and antifungal treatments to ensure that the fungus does not return. This type of infection is rare in the United States.

Mycetoma Fungal Sinusitis. Similar to CIFR, the spread of the infection is very gradual, lasting weeks or months. Fungal organisms make their way into the sinus tissues and cause severe inflammation. Surgery is the most effective treatment. Antifungal treatment is generally not required after surgical fungal ball removal.

Left: Typical sinus CT scan of a patient with Mycetoma Fungal Sinusitis of the right maxillary sinus. Right: View from an endoscope during sinus surgery to remove fungal material and restore sinus drainage.

Fungal Sinus Infection Causes

The cause of fungal sinus infections depend are twofold. The first and most common is believed to be the immune system seeing fungus that is inhaled as a foreign substance and fighting the fungal spores by increasing the immune response. The damage is mostly done in this case by our own bodies. The second type of fungal sinusitis is when the fungus actually reproduces in our sinuses. The fungus can replicate in place, or spread into the surrounding tissues especially when the immune system is compromised.


Fungal Sinus Infection Symptoms

If you seek treatment for your fungal sinus infection, it is important to communicate all of your symptoms to your doctor. In determining whether or not you are suffering from a fungal sinus infection, your doctor will examine you and may use digital imaging to pinpoint fungal debris in the paranasal sinuses. The paranasal sinus most frequently affected is the maxillary sinuses. Specific symptoms that point to a fungal sinus infection include:

  • Sinus pressure and pain
  • Nasal discharge
  • Swelling and inflammation of the sinuses


Fungal Sinus Infection Risk Factors

Fungal sinus infections can be caused by many things but the risk factors may be inevitable which may lead to a sinus infection, such as:

  • Smoking and Secondhand Smoke
  • Environmental Toxins
  • Exposure to Respiratory Infections


Fungal Sinus Infections & Preventative Tips

The root cause of fungal sinus infections is the exposure to fungus and mold spores in the air. Once inhaled, the fungi can become lodged in the mucosal lining of the paranasal sinuses. If you are particularly susceptible to chronic sinus infections, then your immune system will respond in the form of classic fungal sinusitis symptoms.

Fungal sinus infections can be dangerous, because as your immune system attempts to kill the fungus inside your body, your sinus membranes can become inadvertently damaged. This damage is what evokes the common symptoms of a sinus infection.

To prevent the onset of symptoms, try these all-natural ways to lower your exposure to fungus in your environment.

1. Nix foods containing sugar or grains from your diet

Did you know that fungus has a favorite food? They love to feed on sugars and grains especially, so minimizing your intake is key to keeping the fungus at bay.

2. Use coconut oil

Coconut oil is known for its antifungal properties, which is why it is a fabulous addition to your diet, and a healthier substitute for butter or vegetable oil. A pint of extra virgin coconut oils ranges from between $12-$18. However, there are many different form of coconut oil, and it is important to select the proper type. Make sure it is manufactured by a company that only uses fresh coconuts, to ensure that the oil is not contaminated with mycotoxins.

Coconut oil is known for its anti-fungal properties. Use it as a substitute for butter or vegetable oil.

3. Avoid mycotoxin foods

Those who are particularly sensitive to mold or fungus are often told to avoid foods containing mycotoxins. Mycotoxin foods contain a particular blend of agents that cause allergic reactions in people with mold or fungus sensitivities.

Avoiding the following 10 types of food and beverage will decrease the amount of fungus you are exposed to in your diet.

  1. Alcohol
  2. Corn
  3. Wheat
  4. Barley
  5. Sugar
  6. Peanuts
  7. Hard Cheeses
  8. Rye
  9. Sorghum
  10. Cottonseed

4. Eat more fish

Creating a diet high in fish consumption is another important way to reduce fungal infection. Introducing cod liver oil into your diet is also helpful. Both fish and cod liver oil contain omega-3 fats, DHA and EPA, which contribute to a healthy immune system. Fish (especially salmon) and cod liver oil is also known for jumpstarting brain health and is may reduce the risk of cancer and memory loss. Remember, there are no substitutes, not even an omega-3 supplement, that will give you the same nutrients and benefits as fish and cod liver oil.

Pick up a bottle of cod liver oil at your local health and nutrition store for a healthier immune system.


Fungal Sinus Infection Treatment

The treatment for fungal sinusitis depends on the type and cause of the fungal sinus infection. Surgery may be needed emergently when the infection enters the tissue and causes rapid tissue and nerve damage. Fortunately, this is rare and generally occurs in patients with a weakened immune system. Decreasing inflammation with steroids and saline irrigations can decrease symptoms.  Immunotherapy can increase the body’s tolerance to fungal exposure. The condition tends to recur and should be managed by your otolaryngologist or allergist.

Meet Norelle Health

Moustafa Mourad, MD, FACS is double board-certified in Head and Neck Surgery and Facial Plastic Surgery and Reconstruction. He is a Fellow of the American College of Surgeons and a Member of the American Academy of Facial Plastic and Reconstructive Surgery. He treats many conditions,... Learn More »