The mold conundrum in chronic rhinosinusitis: where do we stand today?

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Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
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Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber

Published on: March 3, 2023

Fenna A Ebbens1, Wytske J Fokkens

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Center, Amsterdam, The Netherlands. f.a.ebbens@amc.uva.nl

Current Allergy and Asthma Reports
|April 18, 2008
PubMed

Insights

Fungi are commonly found in the nose and sinuses, but evidence does not support their role in chronic rhinosinusitis (CRS). Antifungal treatments have not shown clinical improvement for CRS patients.

Area of Science:

  • Immunology
  • Otolaryngology
  • Microbiology

Background:

  • Chronic rhinosinusitis (CRS) is a nasal and sinus inflammatory condition.
  • Bacteria are traditionally considered primary pathogens, but fungal involvement is debated.
  • Fungi are ubiquitous in the nasal passages and sinuses of both healthy individuals and CRS patients.

Purpose of the Study:

  • To review the proposed mechanisms linking fungal presence to CRS development.
  • To evaluate the evidence for fungal involvement in CRS pathogenesis.
  • To assess the efficacy of antifungal therapies in managing CRS.

Main Methods:

  • Review of recent studies on fungal identification in CRS.
  • Analysis of proposed immunological mechanisms.
  • Evaluation of clinical trial data for antifungal treatments.

Main Results:

  • Fungi are detected in nearly all individuals, including CRS patients, under optimal conditions.
  • Preliminary trials suggested benefits from antifungal agents, but rigorous placebo-controlled studies did not confirm these findings.
  • Lack of convincing immunologic data and clinical evidence of improvement with antifungal therapy.

Conclusions:

  • The role of fungi as a causative agent in chronic rhinosinusitis remains unproven.
  • Further research with adequate controls is needed to elucidate potential fungal involvement.
  • Current evidence does not support the use of antifungal agents for treating CRS.

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