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Fungus balls of the paranasal sinuses
1Division of Sino-nasal Disorders and Allergy, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Abstract:
Fungus balls of the paranasal sinuses represent a noninvasive manifestation of fungal sinusitis. Patients are immunocompetent but no more allergic than the general population. There is little tissue reaction to the tangled mat of hyphae. If the patient becomes immunocompromised, then the fungus ball may become invasive, as illustrated by an included case report. One hundred sixty-three additional cases of patients with paranasal sinus fungus balls are reviewed from the literature.
Insights
Fungus balls in the paranasal sinuses are a noninvasive fungal sinusitis form. In immunocompetent individuals, they rarely become invasive, but risk increases with compromised immunity.
Area of Science:
- Otolaryngology
- Mycology
- Immunology
Background:
- Fungus balls of the paranasal sinuses are a noninvasive manifestation of fungal sinusitis.
- Patients are typically immunocompetent and not unusually allergic.
- Minimal tissue reaction is observed around the fungal hyphae.
Purpose of the Study:
- To describe the characteristics of paranasal sinus fungus balls.
- To review the potential for invasiveness in immunocompromised patients.
- To analyze a case report and literature review of 163 additional cases.
Main Methods:
- Literature review of 163 cases of paranasal sinus fungus balls.
- Inclusion of a case report illustrating invasive potential.
- Analysis of patient immune status and allergic profiles.
Main Results:
- Paranasal sinus fungus balls are generally noninvasive in immunocompetent hosts.
- A case report demonstrated invasive fungal sinusitis developing from a fungus ball in an immunocompromised patient.
- The literature review supports the rarity of invasiveness in non-compromised individuals.
Conclusions:
- Fungus balls are a distinct, noninvasive entity within fungal sinusitis.
- Immunocompromised status is a critical factor for potential invasion.
- Further research may explore preventative strategies for at-risk populations.
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