There are many common misconceptions regarding fungal sinusitis, and a tremendous amount of false information is available on the Internet. Virtually all cases of “fungal sinusitis” are really allergic fungal sinusitis. Allergic fungal sinusitis is not a fungal infection, but rather an allergy to one of several, common varieties of a fungi found in the soil. We are all constantly exposed to these varieties, but those of us with an allergy to the fungus can develop very severe sinus and nasal symptoms. The allergic reaction causes swelling in nose and in the sinus cavities, and the sinus drainage pathways stopped working. Secretions accumulate within the sinus cavities and bacterial infections begin to develop. These patients are typically treated with antibiotics and will often have temporary belief of symptoms, since the bacterial infection resolves temporarily. However, the ongoing problem of poor sinus drainage continues, and the infections return. Treatment requires repair of the obstructed drainage pathways and usually requires treating of the underlying allergy.True fungal sinusitis is a very serious infection and usually occurs in patients who have a compromised immune system. I have had many patients who were misled into thinking they had this form of fungal sinusitis, rather than the allergic fungal sinusitis that was actually present.
Christopher Thompson, MD
