After years of believing that sinusitis was strictly a bacterial or viral infection, research emerged in the late 1990s that showed sinusitis is sometimes caused by a fungal infection. In cases of chronic sinusitis that do not improve with antibiotics or decongestants, ENT doctors suspect that the body’s immune system is reacting to a fungal invader, causing the sinus cavities to remain irritated.

Fungal sinusitis occurs when fungi organisms, like mold, invade the sinus cavities. It is not unusual for fungi to make their way into your airways — these organisms are ubiquitous in our surroundings — we inhale them every day. However, when the immune system is suppressed, fungi can take up residence in the sinuses, attracted by the damp, dark environment.

Recognizing the Symptoms of Fungal Sinusitis

Unfortunately, there’s no quick-and-easy way to differentiate fungal sinusitis from other forms of sinusitis. Sinusitis symptoms are similar across the different types and, often, people have touches of more than one form.

“Sinus infections can be bacterial, viral, or fungal, but usually they are mixed,” says Jordan S. Josephson, MD, director of the New York Nasal and Sinus Center in Manhattan and author of Sinus Relief Now. “Sometimes a viral infection will start, then it becomes bacterial and then fungal.”

Sinusitis, whether viral, bacterial, or fungal in nature, normally produces all or some of the following symptoms: facial pain or pressure, headache, fever, nasal congestion and discharge, pain in the upper teeth, coughing, bad breath, and a diminished sense of smell.

“People with fungal infections sometimes say they smell dirty socks, but that is rare,” says Dr. Josephson. “To really determine whether your sinusitis is fungal, you have to go see a doctor and get tested.”

Types of Fungal Sinusitis, and Ways to Treat It

Unlike bacterial sinusitis, fungal sinusitis doesn’t respond to antibiotic treatment. Nor does it resolve by taking decongestants. This means that fungal sinusitis is difficult to treat, forcing ENT doctors to do some investigative work to determine the best course of action.

One type of fungal sinusitis, known as a fungal ball, is essentially a clump of spores in the maxillary sinuses. Aspergillus, one of the most common forms of mold, is usually to blame for this kind of fungal sinusitis, which is relatively mild in severity. Fungal balls can be easily removed with a minimally invasive procedure called endoscopic sinus surgery.

Endoscopic sinus surgery also is the best treatment for allergic fungal sinusitis. However, with this kind of fungal sinusitis, caused by common fungi, including Alternaria, Bipolaris, and Curvularia, recurrence rates are higher because nasal polyps and allergic inflammation are usually involved.

A more serious and less common category of fungal sinusitis is known as invasive sinusitis. Although common environmental fungi are to blame for this type of sinusitis as well, it involves an infection that extends beyond the sinuses and nasal cavity. Surgery and anti-fungal medications are usually required to treat invasive sinusitis.

Mold-Proofing Your Home to Avoid Fungal Sinusitis

Because mold is often considered a potential culprit in cases of fungal sinusitis, one of the most beneficial approaches to fungal sinusitis is preventive — mold-proofing your home. The main element that mold needs to grow is moisture. This means that any places in your home that are susceptible to dampness, such as basements, bathrooms, and kitchens, are especially ripe for mold growth. Mattresses, upholstered furniture, pillows, and anything else that can trap dampness also attract mold.

The following steps can help decrease the likelihood of mold growth in your home and improve your chances of avoiding fungal sinusitis:

  • Keep moist rooms as clean and well aired as possible.
  • Avoid humidifiers during months when humidity is normal or high (they can be useful in the winter, when dry air can irritate sinuses).
  • Don’t have too many houseplants and dried flowers, as they both tend to attract mold.
  • Repair leaky faucets and pipes.
  • If mold is found, clean the area with bleach and detergent.
  • In winter, avoid wearing wet boots in the house and, in summer, avoid leaving wet towels and bathing suits lying around.

You can avoid fungal sinusitis and other health conditions caused by mold if you know how it affects your health and by establishing some procedures to thwart its growth.
