Fungus balls of the paranasal sinuses

B J Ferguson1

  • 1Division of Sino-nasal Disorders and Allergy, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

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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