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Allergic fungal sinusitis affects 15% of people in the US, causing a build-up of fungus and mucus in the sinus cavity. Symptoms include fever, swelling, and pain. Treatment includes medication, immunotherapy, and surgery. The type of environmental fungi varies by location.
Many people are exposed to environmental fungi on a regular basis without experiencing serious effects. Other people develop an allergic reaction known as allergic fungal sinusitis (AFS). The condition affects about 15% of people in the United States.
Allergic fungal sinusitis is characterized by the presence of mucin, which is a combination of fungus and mucus that builds up in the sinus cavity and creates a blockage. Mucin ranges in color from tan to dark green or even black. Symptoms of infection include fever, swelling around the eyes, pus-filled discharge from the nose and throat, headache, earache, and pain in the teeth or face. Some people also experience stuffy nose, sore throat or cough. In severe cases of allergic fungal sinusitis, the blockage in the sinus can press outward, making the face and eyes appear bumpy or asymmetrical.
The type of environmental fungi varies according to the geographical location. Curvularia and Bipolaris fungi are most commonly responsible for allergic fungal sinusitis infections in the United States. Curvularia infections are most common in the southeast, while Bipolaris fungus affects people in the western and central regions. Aspergillus, Alternaria, Fusarium and many others also cause allergic reactions or infections in predisposed people.
Adolescents and young adults are in a higher risk category of developing allergic fungal sinusitis than middle-aged or older people. Men and women are infected at approximately equal rates, although women tend to be slightly older than men at the time of infection. People with weak immune systems are at a higher risk of developing symptoms. People who live in hot, humid climates are more at risk than those who live in cool or dry places.
Several approaches are commonly used to treat allergic fungal sinusitis. Fungicidal drugs and oral antibiotics are usually given first. Patients are often treated with medications such as antihistamines that reduce allergy symptoms or corticosteroids to reduce swelling. Doctors may also recommend immunotherapy procedures such as allergy shots to reduce the body’s allergic reaction to the fungus. People who don’t respond to medical treatment or immunotherapy may require surgery.
Most surgical procedures are performed on an outpatient basis using a local anesthetic. In a procedure called functional endoscopic sinus surgery (FESS), your doctor inserts a viewing tube into your nose. The device contains a light and a camera so your doctor can see inside your sinus cavity. Your doctor will use specialized tools to remove the blockage.
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