WHAT ARE NONINVASIVE TYPES ?
There are different types of noninvasive, one type is characterized by fungus growing over nasal crusts. The patient will complain of foul smelling odour coming from the nose, and are treated with removal of the crusts and cleaning the area to prevent formation of a fungal ball. FUNGAL BALL is an accumulated fungal elements within the sinus to form a ball, usually seen in middle aged patients. Treatment is to remove the fungal ball.
ALLERGIC FUNGAL SINUSITIS is another type of noninvasive, which is due to an allergic reaction to the fungal elements in the sinuses. Patients are usually young, with presence of nasal polyp, hypersensitivity reaction and often have asthma history. There will be eosinophilia and usually it is one sided. They present with nasal block, nasal discharge which is thick sticky yellowish or greenish and associated polyp . Allergic tests, radiological investigation and fungal culture will aid in diagnosis. Treated with topical and systemic antifungals.
WHAT ARE INVASIVE TYPES ?
They are life threatening, seen in patients with low immunity like uncontrolled DIABETES, malignancy, those on immunosuppressive drugs and other immunodeficiency diseases. Fungal elements invade the soft tissue, blood vessels and bones causing destruction and bleeding. There will be cough, headache, fever ,crusting of nasal mucosa, nasal bleeding with ulceration of nasal mucosa. Bone erosion can cause spread into the orbit (eye) and brain. Treatment should be done immediately using antifungals.
Other type is FUNGAL GRANULOMA where granulomatous tissue causes bulging of the eyeball nose and sinuses. Granuloma has to be removed and treated with antifungals.
CHRONIC INVASIVE type are slowly destructive seen in Diabetes, those on immunosuppressive drugs. Fungal elements are seen in nose and sinuses and has to be removed and given antifungals.
This topic was selected to create awareness about fungal infection.
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