fungal rhinosinusitis

Question 1

broadly what are the types of fungal rhinosinusitis ?

Answer 1

non invasive and invasive

Question 2

what are the types of non invasive fungal rhinosinusitis ?

Answer 2

allergic fungal sinusitis
sinus mycetoball

Question 3

what are the types of invasive fungal rhinosinusitis ?

Answer 3

acute invasive fungal sinusitis
chronic invasive fungal sinusitis
granulomatous invasive fungal sinusitis

Question 4

what type of patient are commonly affected by allergic fungal sinusitis ?

Answer 4

immunocompetent patients who have asthma and high levels of fungi specific IgE and eosinophilia

Question 5

what is allergic fungal sinusitis a reaction to ?

Answer 5

reaction to aerosolized environmental fungi

Question 6

what is the usual presentation of allergic fungal rhinitis ?

Answer 6

unilateral nasal polyps

Question 7

what is the imaging used for the diagnosis of allergic fungal sinusitis ?

Answer 7

CT
shows opaccification with concretions

Question 8

what is the treatment for allergic fungal rhinitis ?

Answer 8

FESS
topical steroids +/- S steroids

Question 9

what is diagnostically found during surgery in allergic fungal sinusitis ?

Answer 9

peanut butter mixed with sand and glue
allergic mucin

Question 10

what is the immunity status of patients with invasive vs non invasive fungal rrhinosinusitis ?

Answer 10

only one highly associated with immunocompromised is acute invasive fungal sinusitis

Question 11

what structures arw affected in mycetoma ball ?

Answer 11

maxillary sinus

Question 12

what is often the presentation of mycetoma ball ?

Answer 12

often asymptomatic
involves the maxillary sinus
patient may complain of blowing gravel like material from the nose

Question 13

what is the treatment for mycetoma ball ?

Answer 13

FESS

Question 14

at the time of surgery in mycetoma ball what is present ?

Answer 14

cheesy or clay like material is present at the time of surgery

Question 15

what are the organisms responsible for acute invasive fungal sinusitis ?

Answer 15

rhizomucor
rhizopus

Question 16

how does spread happen in invasive acute fungal sinusitis ?

Answer 16

vascular invasion
vasculitis into the orbit and the CNS

Question 17

what are the pathognomonic changes seen in active fungal sinusitis ?

Answer 17

blackk ulcers sen on the septum on the turbinates or the palate

Question 18

what is the treatment for acute invasive fungal sinusitis ?

Answer 18

hospitalization
correct blood sugar
systemic antifungals
surgical deb may be needed

Question 19

what is the presentation associated with acute invasive fungal sinusitis ?

Answer 19

altered mental status
fever
cough
nasal discharge
headache

Question 20

what type of patients can get chronic inv fungal sinusitis ?

Answer 20

both immunocompromised and immunocompetent

Question 21

what is the presentation of chronic inv fungal sinusitis ?

Answer 21

not acute
not as aggressive as acute form
no altered mental status
nasal examination can be minimal

Question 22

what is the trreatment for chronic inv fungal sinusitis

Answer 22

surgical debridement
systemic antifungals

Question 23

what kind of patient gets granulomatous invasive fungal sinusitis ?

Answer 23

immunocompeteent

Question 24

what is a common finding associated with granulomatous invasive fungal sinusitis ?

Answer 24

proptosis
examination of the nasal cavity is often non revealing

Question 25

what is the treatment for granulomatous invasive fungal sinusitis ?

Answer 25

systemic antifungals and surgical debridement