About all

Mold in the sinuses: Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit?

by alexxlab

Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit?

1. Dennis D.P. Chronic defective T-cells responding to superantigens, treated by reduction of fungi in the nose and air. Arch. Environ. Health. 2003;58:433–451. [PubMed] [Google Scholar]

2. Dennis D.P., Roberson D., Curtis L., Black J. Fungal exposure endocrinopathy with growth hormone deficiency; Dennis-Robertson syndrome. Toxicol. Ind. Health. 2009;25:669–680. doi: 10.1177/0748233709348266. [PubMed] [CrossRef] [Google Scholar]

3. Rea W.J., Didriksen N., Simon T.R., Pan Y., Fenyves E.J., Griffiths G. Effects of toxic exposure to mold and mycotoxins in building-related illnesses. Arch. Environ. Health. 2003;58:399–405. [PubMed] [Google Scholar]

4. Campbell A., Thrasher J.D., Gray M.R., Vojdani A. Mold and mycotoxins: Effects on the neurological and immune systems in humans. Adv. Appl. Microbiol. 2004;55:375–398. doi: 10.1016/S0065-2164(04)55015-3. [PubMed] [CrossRef] [Google Scholar]

5. Gray M.R., Thrasher J.D., Crago R., Madison R.A., Arnold L., Campbell A.W., Vojdani A. Mixed mold mycotoxicosis: Immunological changes in humans following exposure to water damaged buildings. Arch. Environ. Health. 2003;58:410–420. [PubMed] [Google Scholar]

6. Kilburn K.H. Neurobehavioral and pulmonary impairment in 105 adults with indoor exposure to molds compared to 100 exposed to chemicals. Toxicol. Ind. Health. 2009;35:681–692. doi: 10.1177/0748233709348390. [PubMed] [CrossRef] [Google Scholar]

7. Empting L.D. Neurologic and neuropsychiatric syndrome features of mold and mycotoxin exposure. Toxicol. Ind. Health. 2009;25:577–581. doi: 10.1177/0748233709348393. [PubMed] [CrossRef] [Google Scholar]

8. Park J.H., Cox-Ganser J.M. Mold exposure and respiratory health in damp indoor environments. Front. Biosci. 2011;E3:757–771. doi: 10.2741/e284. [PubMed] [CrossRef] [Google Scholar]

9. Fisk W.J., Eliseeva E.A., Mendell M.J. Association of residential dampness and mold with respiratory tract infections and bronchitis: A meta-analysis. Environ. Health. 2010;9:72. doi: 10.1186/1476-069X-9-72. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

10. Park J.H., Kreiss K., Cox-Ganser J.M. Rhinosinusitis and mold as risk factors for asthma symptoms in occupants of a water-damaged building. Indoor Air. 2012;22:396–404. doi: 10.1111/j.1600-0668.2012.00775.x. [PubMed] [CrossRef] [Google Scholar]

11. Tercelj M., Salobir B., Harlander M., Rylander R. Fungal exposure in homes of patients with sarcoidosis—An environmental exposure study. Environ. Health. 2011;10:8. doi: 10.1186/1476-069X-10-8. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

12. Laney A.S., Cragin L.A., Blevins L.Z., Sumner A.D., Cox-Ganser J.M., Kreiss K., Moffatt S.G., Lohff C.J. Sarcoidosis, asthma and asthma-like symptoms among occupants of a historically water-damaged office building. Indoor Air. 2009;19:83–90. doi: 10.1111/j.1600-0668.2008.00564.x. [PubMed] [CrossRef] [Google Scholar]

13. Chester A.C., Levine P. Concurrent sick building syndrome and chronic fatigue syndrome: Epidemic neuromyasthenia revisited. Clin. Infect. Dis. 1994;18:S43–S48. doi: 10.1093/clinids/18.Supplement_1.S43. [PubMed] [CrossRef] [Google Scholar]

14. Brewer J.H., Thrasher J.D., Straus D.C., Madison R.A., Hooper D. Detection of mycotoxins in patients with chronic fatigue syndrome. Toxins. 2013;5:605–617. doi: 10.3390/toxins5040605. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

15. Polizzi V., Delmulle B., Adams A., Moretti A., Susca A., Picco A.M., Rosseel Y., Kindt R., van Bocxlaer J., de Kimpe N., et al. JEM Spotlight: Fungi, mycotoxins and microbial volatile organic compounds in mouldy interiors from water-damaged buildings. J. Environ. Monit. 2009;11:1849–1858. doi: 10.1039/b906856b. [PubMed] [CrossRef] [Google Scholar]

16. Smoragiewicz W., Cossette B., Boutard A., Kryzvstyniak K. Trichothecene mycotoxins in the dust of ventilation systems in office buildings. Int. Arch. Occup. Environ. Health. 1993;65:113–117. doi: 10.1007/BF00405729. [PubMed] [CrossRef] [Google Scholar]

17. Täubel M. , Sulyok M., Vishwanath V., Bloom E., Turunen M., Järvi K., Kauhanen E., Krska R., Hyvärinen A., Larsson L., et al. Co-occurrence of toxic bacterial and fungal secondary metabolites in moisture-damaged indoor environments. Indoor Air. 2011;21:368–375. doi: 10.1111/j.1600-0668.2011.00721.x. [PubMed] [CrossRef] [Google Scholar]

18. Gottschalk C., Bauer J., Meyer K. Detection of Satratoxin G and H in indoor air from a water-damaged building. Mycopatholgia. 2008;166:103–107. doi: 10.1007/s11046-008-9126-z. [PubMed] [CrossRef] [Google Scholar]

19. Brasel T.L., Martin J.M., Carriker C.G., Wilson S.C., Straus D.C. Detection of airborne Stachybotrys chartarum macrocyclic trichothecenes in the indoor environment. Appl. Environ. Microbiol. 2005;71:7376–7388. [PMC free article] [PubMed] [Google Scholar]

20. Thrasher J.D., Crawley S. The biocontaminants and complexity of damp indoor spaces: More than meets the eyes. Toxicol. Ind. Health. 2009;25:583–615. doi: 10.1177/0748233709348386. [PubMed] [CrossRef] [Google Scholar]

21. Straus D.C. Molds, mycotoxins, and sick building syndrome. Toxicol. Ind. Health. 2009;25:617–635. doi: 10.1177/0748233709348287. [PubMed] [CrossRef] [Google Scholar]

22. Pestka J.J., Yike I., Dearborn D.G., Ward M.D., Harkema J.R. Stachybotrys chartarum, trichothecenes mycotoxins, and damp building-related illness: New insights into a public health enigma. Toxicol. Sci. 2008;104:4–26. doi: 10.1093/toxsci/kfm284. [PubMed] [CrossRef] [Google Scholar]

23. Fukuda K., Strauss S.E., Hickie I., Sharpe M.C., Dobbins J.G., Komaroff A. The chronic fatigue syndrome: A comprehensive approach to its definition and study. Ann. Intern. Med. 1994;121:953–959. doi: 10.7326/0003-4819-121-12-199412150-00009. [PubMed] [CrossRef] [Google Scholar]

24. Ostry V., Malir F., Ruprich J. Producers and important dietary sources of ochratoxin A and citrinin. Toxins. 2013;5:1574–1586. doi: 10.3390/toxins5091574. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

25. Thrasher J.D., Gray M.R., Kilburn K.H., Dennis D., Yu A. A water-damaged home and health of occupants: A case study. J. Environ. Public Health. 2012 doi: 10.1155/2012/312836. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

26. Dennis D.P. (Atlanta Center for E.N.T. & Facial Plastic Center, Atlanta, GA, USA). Personal Communication. 2010.

27. Ponikau J.U., Sherris D.A., Kern E.B., Homeburger H.A., Frigas E., Gaffey T.A., Roberts G.D. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin. Proc. 1999;74:877–884. [PubMed] [Google Scholar]

28. Braun H., Buzina W., Freudenschuss F., Beham A., Stammberger H. “Eosinophilic fungal rhinosinusitis”: A common disorder in Europe? Laryngoscope. 2003;113:264–269. doi: 10.1097/00005537-200302000-00013. [PubMed] [CrossRef] [Google Scholar]

29. Murr A.H., Goldberg A.N., Pletcher S.D., Dillehay K., Wymer L.J., Vesper S.J. Some chronic rhinosinusitis patients have elevated populations of fungi in their sinuses. Laryngoscope. 2012;122:1438–1445. doi: 10.1002/lary.23295. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

30. El-Morsy S.M., Khafagy Y.W., El-Naggar M.M., Beih A.A. Allergic fungal rhinosinusitis: Detection of fungal DNA in sinus aspirate using polymerase chain reaction. J. Layrngol. Otol. 2010;124:152–160. doi: 10.1017/S0022215109991204. [PubMed] [CrossRef] [Google Scholar]

31. Guo C., Ghadersohi S., Kephart G.M., Laine R.A., Sherris D.A., Kita H., Ponikau J.U. Improving detection of fungi in eosinophilic mucin: Seeing what we could not see before. Otolaryngol. Head Neck Surg. 2012;147:943–949. doi: 10.1177/0194599812451010. [PubMed] [CrossRef] [Google Scholar]

32. Lewis R.E., Wiederhold N.P., Chi J., Han X.Y., Komanduri K.V., Kontoyiannis D.P., Prince R.A. Detection of gliotoxin in experimental and human aspergillosis. Infect. Immun. 2005;73:636–637. [PMC free article] [PubMed] [Google Scholar]

33. Korbel R., Bauer J., Gedek B. Pathologico-anatomic and mycotoxicologic studies of aspergillosis in birds. Tierarit Prax. 1998;21:134–139. [PubMed] [Google Scholar]

34. Bauer J., Gaareis M., Bott A., Gedek B. Isolation of a mycotoxin (gliotoxin) from a bovine udder infected with Aspergillus fumigatus. J. Med. Vet. Mycol. 1989;27:45–50. doi: 10.1080/02681218980000061. [PubMed] [CrossRef] [Google Scholar]

35. Richard J.L., Debey M.C. Production of gliotoxin during pathogenic state in turkey poults by Aspergillus fumigatus. Fresneius Mycopathol. 1995;129:111–115. [PubMed] [Google Scholar]

36. Matsumara M., Mori T. Detection of aflatoxins in autopsied materials from a patient infected with Aspergillus flavus. Jpn. J. Med. Mycol. 1998;39:267–271. [Google Scholar]

37. Ohtomo T., Murkakoshi S., Sugiyama S., Kurata H. Detection of aflatoxin B1 in silkworm larvae attached by an Aspergillus flavus isolate from a sericultural farm. Appl. Microbiol. 1975;39:1034–1035. [PMC free article] [PubMed] [Google Scholar]

38. Bruns S., Seidler M., Albrecht D. , Salvenmoser S., Remme N., Hertweck C., Brakhage A.A., Kniemeyer O., Müller F.M. Functional genome profiling of Aspergillus fumigatus biofilm reveals enhanced production of the mycotoxin gliotoxin. Proteomics. 2010;10:3097–3107. doi: 10.1002/pmic.201000129. [PubMed] [CrossRef] [Google Scholar]

39. Fanning S., Mitchell A.P. Fungal biofilms. PLoS Pathog. 2012;8:1–4. [Google Scholar]

40. Lieberman S.M., Jacobs J.B., Lebowitz R.A., Fitzgerald M.B., Crawford J., Feigenbaum B.A. Measurement of mycotoxins in patients with chronic rhinosinusitis. Otolaryngol. Head Neck Surg. 2011;145:327–329. doi: 10.1177/0194599811403891. [PubMed] [CrossRef] [Google Scholar]

41. Hooper D.G., Bolton V.E., Guilford F.T., Straus D.C. Mycotoxin detection in human samples from patients exposed to environmental molds. Int. J. Mol. Sci. 2009;10:1465–1475. doi: 10.3390/ijms10041465. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

42. Brasel T.L., Campbell A.W., Demers R.E., Ferguson B. S., Fink J., Vojdani A., Wilson S.C., Straus D.C. Detection of trichothecene mycotoxins in sera from individuals exposed to Stachybotrys chartarum in indoor environments. Arch. Environ. Health. 2004;59:317–323. [PubMed] [Google Scholar]

43. Layton R.C., Purdy C.W., Jumper C.A., Straus D.C. Detection of macrocyclic trichothecene mycotoxins in a caprine (goat) tracheal instillation model. Toxicol. Ind. Health. 2009;25:693–701. doi: 10.1177/0748233709348275. [PubMed] [CrossRef] [Google Scholar]

44. Gorny R.L., Reponen T.L., Willeke K., Schmechel D., Robine E., Boissier M., Grinshpun S.A. Fungal fragments as indoor air biocontaminants. Appl. Environ. Microbiol. 2002;68:3522–3531. doi: 10.1128/AEM.68.7.3522-3531.2002. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

45. Gorny R.L. Filamentous microorganisms and their fragments in indoor air—A review. Ann. Agric. Environ. Med. 2004;11:185–197. [PubMed] [Google Scholar]

46. Cho S.-H., Seo S.-C., Schmechel D. , Grinshpun A.G., Reponen T. Aerodynamic characteristics and respiratory deposition of fungal fragments. Atmos. Environ. 2005;39:5454–5465. doi: 10.1016/j.atmosenv.2005.05.042. [CrossRef] [Google Scholar]

47. Reponen T., Seo S.-C., Grimsley F., Lee T., Crawford C., Grinshpun S.A. Fungal fragments in moldy houses: A field study in homes in New Orleans and Southern Ohio. Atmos. Environ. 2007;41:8140–8149. doi: 10.1016/j.atmosenv.2007.06.027. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

48. Gorny R.L., Lawniczek-Walczyk A. Effect of two aerosololization methods on the release of fungal propagules from a contaminated agar surface. Ann. Agric. Environ. Med. 2012;19:279–284. [PubMed] [Google Scholar]

49. Scott J. An Evolving Architecture: Past, Present & Future and Indoor Microbiology; Proceedings of the Indoor Air Quality Association 15th Annual Meeting and Indoor Air Expos; Las Vegas, NV, USA. 5–7 March 2012. [Google Scholar]

50. Ponikau J.U., Sherris D. A., Hirohito K., Kern E.B. Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis. J. Allergy Clin. Immunol. 2002;110:862–866. doi: 10.1067/mai.2002.130051. [PubMed] [CrossRef] [Google Scholar]

51. Ponikau J.U., Sherris D.A., Weaver A., Kita H. Treatment of chronic rhinosinusitis with intranasal amphotericin B: A randomized, placebo-controlled, double-blind pilot trial. J. Allergy Clin. Immunol. 2005;115:125–131. doi: 10.1016/j.jaci.2004.09.037. [PubMed] [CrossRef] [Google Scholar]

52. Kern E.B., Sherris D., Stergiou A.M., Katz L., Rosenblatt L.C., Ponikau J. Diagnosis and treatment of chronic rhinosinusitis: A focus on intranasal Amphotericin B. Ther. Clin. Risk Manag. 2007;3:319–325. doi: 10.2147/tcrm.2007.3.2.319. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

53. Chakrabarti A., Denning D.W., Ferguson B.J., Ponikau J., Buzina W., Kita H., Marple B., Panda N., Vlaminck S., Kauffmann-Lacroix C., et al. Fungal rhinosinusitis: A categorization and definitional schema addressing current controversies. Laryngoscope. 2009;119:1809–1818. doi: 10.1002/lary.20520. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

54. Siddiqui A., Shah A.A., Bashir S.H. Craniocerebral aspergillosis of sinonasal origin in immunocompetent patients: Clinical spectrum and outcome of 25 cases. Neurosurgery. 2004;44:602–613. doi: 10.1227/01.NEU.0000134597.94269.48. [PubMed] [CrossRef] [Google Scholar]

55. Gosepath J., Brieger J., Vlachtsis K., Mann W.J. Fungal DNA is present in tissue specimens of patients with chronic rhinosinusitis. Am. J. Pathol. 2004;18:9–13. [PubMed] [Google Scholar]

56. Gray M.R. (Progressive Health Care Group, Benson, AZ, USA). Personal communication. 2012.

57. Bristol-Myers Squibb . Fungizone Product Monograph. Bristol-Myers Squibb Canada; Montreal, Canada: 2009. [Google Scholar]

58. Geronikaki A., Fesatidou M., Kartsey V., Macaey F. Synthesis and biological evaluation of potent antifungal agents. Curr. Top. Med. Chem. 2013;13:2684–2733. [PubMed] [Google Scholar]

59. Kidane Y.H., Lawrence C., Murali T.M. Computational approaches for discovery of common immunomodulators in fungal infections: Towards broad-spectrum immunotherapeutic interventions. BMC Microbiol. 2013;13 doi: 10.1186/1471-2180-13-224. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

60. Foreman A., Psaltis A.J., Tan L.W., Wormald P.J. Characterization of bacterial and fungal biofilms in chronic rhinosinusitis. Am. J. Rhinol. Allergy. 2009;23:556–561. [PubMed] [Google Scholar]

61. Pintucci J.P., Corno S., Garotta M. Biofilms and infections of the upper respiratory tract. Eur. Rev. Med. Pharmacol. Sci. 2010;14:683–690. [PubMed] [Google Scholar]

62. Singhal D., Baker L., Wormold P.J., Tan L.W. Aspergillus fumigatus biofilm on primary human sinonasal epithelial culture. Am. J. Rhinol. Allergy. 2011;25:219–225. doi: 10.2500/ajra.2011.25.3622. [PubMed] [CrossRef] [Google Scholar]

63. Rini J.F., Grant I.H. Neurological Disease after Mold Exposure, Immune Risks & Response to Biofilm-Focused Antifungal Therapy; Proceedings of the 52nd Annual Interscience Conference on Antimicrobial Agents and Chemotherapy Conference; San Francisco, CA, USA. 9–12 September 2013. [Google Scholar]

64. Ramage G., Rajendran R., Sherry L., Williams C. Fungal biofilm resistance. Int. J. Microbiol. 2012;2012:528521:1–528521:14. [PMC free article] [PubMed] [Google Scholar]

65. Fey P.D. Modality of bacterial growth presents unique targets: How do we treat biofilm-mediated infections. Curr. Opin. Microbiol. 2010;13:610–615. doi: 10.1016/j.mib.2010.09.007. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

66. Foreman A., Wormald P.J. Different biofilms, different disease? A clinical outcomes study. Laryngoscope. 2010;120:1701–1706. doi: 10.1002/lary.21024. [PubMed] [CrossRef] [Google Scholar]

67. Loussert C., Schmitt C., Prévost M.C., Balloy V., Fadel E., Philippe B., Kauffmann-Lacroix C., Latjé J.P., Beauvais A. The in vivo biofilm composition of Aspergillus fumigatus. Cell. Microbiol. 2010;12:405–410. doi: 10.1111/j.1462-5822.2009.01409.x. [PubMed] [CrossRef] [Google Scholar]

68. Beauvais A., Schmidt C. , Guadagnini S., Roux P., Perret E., Henry C., Paris S., Mallet A., Prévost M.C., Latejé J.C. An extracellular matrix glues together the aerial-grown hyphae of Aspergillus fumigatus. Cell. Microbiol. 2007;9:1588–1600. doi: 10.1111/j.1462-5822.2007.00895.x. [PubMed] [CrossRef] [Google Scholar]

69. Hung C., Zhou Y., Pinkner J.S., Dodson K.W., Crowley J.R., Heuser J., Chapman M.R., Hadjifrangiskou M., Henderson J.P., Hultgren S.J. Escherichia coli biofilms have organized complex extracellular matrix structure. MBio. 2013;4 doi: 10.1128/mBio.00645-13. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

70. Gibbons J.G., Beauvais A., Beau R., McGary L., Latgé J.P., Rokas A. Global transcriptome changes underlying colony growth in the opportunistic human pathogen Aspergillus fumigatus. Eukaryot. Cell. 2012;11:68–78. doi: 10.1128/EC.05102-11. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

71. Shopova I., Bruns S., Thywissen A., Kniemeyer O. , Brakhage A.A., Hillmann F. Extrinsic extracellular DNA leads to biofilm formation and colocalizes with matrix polysaccharides in the human pathogenic fungus Aspergillus fumigatus. Front. Microbiol. 2013;4:141. [PMC free article] [PubMed] [Google Scholar]

72. Muller F.M., Seider M., Beauvais A. Aspergillus fumigatus in the clinical setting. Med. Mycol. 2011;49(Suppl. 1):S96–S100. doi: 10.3109/13693786.2010.502190. [PubMed] [CrossRef] [Google Scholar]

73. Kaur S., Singh S. Biofilm formation by Aspergillus fumigatus. Med. Mycol. 2013 in press. [PubMed] [Google Scholar]

74. Boase D., Jervis-Bardy J., Cieland E., Pant H., Tan L., Wormald P.J. Bacterial-induced epithelial damage promotes fungal biofilm formation in a sheep model of sinusitis. Int. Forum Allergy Rhinol. 2013;3:341–348. doi: 10.1002/alr.21138. [PubMed] [CrossRef] [Google Scholar]

75. Boase S., Valentine R., Singhal D., Tan L.W., Wormald P.J. A sheep model to investigate the role of fungal biofilms in sinusitis: Fungal and bacterial synergy. Int. Forum Allergy Rhinol. 2011;1:340–347. doi: 10.1002/alr.20066. [PubMed] [CrossRef] [Google Scholar]

76. Tan N.C., Tran H.B., Foreman A., Jardeleza C., Vreudge S., Wormold P.J. Identifying intracellular Staphylococcus aureus in chronic rhinosinusitis: A direct comparison of techniques. Am. J. Rhinol. Allergy. 2012;26:444–449. doi: 10.2500/ajra.2012.26.3822. [PubMed] [CrossRef] [Google Scholar]

77. Biel M.A., Brown C.A., Levinson R.M., Garvis G.E., Paisner H.M., Sigel M.E., Tedford T.M. Evaluation of the microbiology of chronic maxillary sinusitis. Ann. Otol. Rhinol. Laryngol. 1998;107:942–945. [PubMed] [Google Scholar]

78. Aral M., Keleş E., Okur E., Alpay H.C., Yilmaz M. The pathogenicity and antibiotic resistance of coagulase-negative Staphylococci isolated from the maxillary and ethmoid sinuses. Rhinology. 2004;42:131–136. [PubMed] [Google Scholar]

79. Aral M., Keles E., Kaygusuz I. The microbiology of ethmoid and maxillary sinuses in patients with chronic rhinosinusitis. Am. J. Otolaryngol. 2003;24:163–168. doi: 10.1016/S0196-0709(02)32420-7. [PubMed] [CrossRef] [Google Scholar]

80. O’Gara J.P., Humphreys H. Staphylococcus epidermidis biofilms: Importance and implications. J. Med. Microbiol. 2001;50:582–587. [PubMed] [Google Scholar]

81. Mack D., Haeder M., Siemssen N., Laufs R. Association of biofilm production of coagulase-negative Staphylococci with expression of a specific polysaccharide intracellular adhesion. J. Infect. Dis. 1996;174:881–884. doi: 10.1093/infdis/174.4.881. [PubMed] [CrossRef] [Google Scholar]

82. Uren B., Psaltis A., Wormold P.J. Nasal lavage with mupirocin for the treatment of surgically recalcitrant chronic rhinosinusitis. Laryngoscope. 2008;118:1677–1680. doi: 10.1097/MLG.0b013e31817aec47. [PubMed] [CrossRef] [Google Scholar]

83. Ebbens F.A., Scadding G.K., Badia L., Hellings P.W., Jorissen M., Mullol J., Cardesin A., Bachert C., van Zele T.P., Dijkgraaf M.G., et al. Amphotericin B nasal lavages: Not a solution for patients with chronic rhinosinusitis. J. Allergy Clin. Immunol. 2006;118:1149–1156. doi: 10.1016/j.jaci.2006.07.058. [PubMed] [CrossRef] [Google Scholar]

84. Mowat E., Butcher J., Lang S., Williams C., Ramage G. Development of a simple model for studying the effects of antifungal agents on multicellular communities of Aspergillus fumigatus. J. Med. Microbiol. 2007;56:1205–1212. doi: 10.1099/jmm.0.47247-0. [PubMed] [CrossRef] [Google Scholar]

85. Mowat E., Lang S., Williams C., McCulloch E., Jones B., Ramage G. Phase-dependent antifungal activity against Aspergillus fumigatus developing multicellular filamentous biofilms. J. Antimicrob. Chemother. 2008;62:1281–1284. doi: 10.1093/jac/dkn402. [PubMed] [CrossRef] [Google Scholar]

86. Venkatesh M., Rong L., Raad I., Versalovic J. Novel synergisitic antibiofilm combinations for salvage of infected catheters. J. Med. Microbiol. 2009;58:936–944. [PubMed] [Google Scholar]

Mold Sinus infection – Fungal Sinusitis

  • Posted on: Sep 20 2019
  • By: Sinus & Snoring Specialists

You may have been told that your sinus infection is a “mold” sinus infection. Typically along with this explanation, you may have been told that there is no good treatment for this condition.

Allergic Fungal Sinusitis (AFS) is a very frustrating condition to treat as it is not like a typical bacterial sinus infection at all.

AFS is actually not an infection, but really an overzealous local immune response in the nasal and sinus tissue to exposure to mold.

Mold spores are very light and are floating in the air.  In patients with AFS, they breathe the mold into their nasal and sinus cavities causing an intense and exuberant short term and long term allergic inflammatory reaction.

The nasal and sinus lining develops severe swelling. This causes a blockage of the sinus outflow tracts, trapping some mold to grow and accumulate inside the sinuses. Associated pooling of sinus secretions creates a secondary bacterial infection in most cases as well.

This persistent reaction fails to respond to traditional medical treatment for sinus infection. Instead, it progresses to develop nasal polyps. These polyps are not malignant but instead, they are just extremely swollen lining that hangs into the nasal airway like large grapes.

The patient is usually miserable, with severe nasal blockage and sinus complaints, with only temporary relief with systemic steroids and antibiotics.

Even if traditional sinus surgery is done, the underlying condition is still present and the polyps tend to recur.  This causes a terrible cycle of treatment failure.

What is the modern way to successfully manage this difficult problem?

After medical therapy has failed, the following treatment algorithm gives the best chance for success:

  1. Non-surgical balloon sinuplasty and removal of polyps as an office procedure under IV sedation. Any other structural issues such as a deviated septum should be addressed at the same time.
  2. Wash out the sinus cavities (Cyclone® lavage) during the balloon sinuplasty, with a solution against inflammation, bacteria, and mold.
  3. Allergy skin test to treat common allergens with allergy drop therapy.   All 4 common mold allergens are added to the drops, even if the patient does not test positive for mold as the allergy.  This allergy can be isolated to the nasal and sinus lining and may not show on testing. These allergy drops make the patient have IgG blocking antibodies to block the allergic reaction before it occurs.
  4. Use new “biologic” treatment – Dupixent. This antibody is injected twice a month at home by the patient. It actually blocks the over-exuberant allergic response to the mold allergy by blocking certain receptor sites that are part of the allergic reaction.
  5. Examine your local home and work environment to reduce mold exposure.

With this comprehensive yet minimally invasive approach, we can have longterm success in treating this previously troublesome condition.

Schedule A Consultation

If you have been told you have AFS, come see us for a consultation and a better approach.   He will perform an in-depth evaluation and determine the best solution for you!  Contact us today at 512.601.0303 to schedule an appointment!

 

Tagged with: Allergic Fungal Sinusitis

Posted in: Allergies, Allergy Drops, Balloon Sinuplasty, Nasal Polyps, Sinus and Nasal

Leave a response

Search for:

▲

90,000 fungus in the maxillary sinus. Everything you need to know about treatment.

CONTENTS:
1. What is a mycetoma?
2. Causes of fungus
3. Inflammation of the sinuses
4. Treatment examples
5. Symptoms
6. How extensive can a mycetoma be?
7. Why is the formation of fungus in the maxillary sinus dangerous?
8. The role of CT in the study
9. How can mycetoma be cured?0007 11. Rehabilitation of the patient
12. Recommendations after removal of the fungus from the maxillary sinus
13. About the author

What is a mycetoma?

Mycetoma of the maxillary sinus is a fungal infection of the maxillary sinuses, which is one of the forms of mycosis. Inflammation of the maxillary sinuses of a non-invasive nature. The mucosa of the maxillary sinuses itself is not damaged by this fungal structure, it does not grow into the mucosa. Mushrooms just grow, the fungal body – mycelium – grows inside the maxillary sinus. At first, the fungal body of the mycetoma may look like a ball, over time, the fungus grows and can occupy the entire maxillary sinus.

Causes of fungus in the maxillary sinus

Is there any predisposition of the body to the appearance of mycetoma or does the fungus appear only as a result of external influences?
It must be pointed out that fungal spores are in the air and surround us all the time. In order for fungal growth to occur in the maxillary sinus, a person must have reduced immunity, he may have severe forms of diabetes, immunodeficiency, as a result of previous drug therapy, the human immune system is suppressed – against this background, mycetoma may also appear in maxillary sinus.

It should also be noted that often the start for the appearance and growth of mycetoma, fungus, mycelium can be the use of zinc preparations, which enters the maxillary sinus.
And one of these factors may be zinc preparations widely used in dentistry.

And when zinc enters the maxillary sinus, this is a very good environment for the appearance of mycetoma. And even in people with normal immunity, with a normal immunological status, mycetoma may appear in this case.

The second factor in the formation of a fungal colony can be a fragment of a dental instrument left by the attending physician during canal probing. The next picture is just such a case:

Inflammation of the maxillary sinuses with a fungus

Often a person does not even suspect that mushrooms grow in his maxillary cavity. Mycetoma symptoms. The patient lives a normal life, perhaps at this moment he has some slight difficulty in breathing, there may be a slight discharge from the nasal mucosa, there may be an unpleasant odor.

Basically, the patient learns that he has a mycetoma during the examination, when he comes to the dentist, does CBCT, and the attending doctor sees a foreign body, a fungal lesion in a detailed study of the image.

Mycetoma symptoms

In the early stages, a patient with mycetoma feels absolutely nothing because there are no symptoms of the disease yet. And as the fungal growth increases in size, it will become more difficult for the patient to breathe due to nasal congestion on one side, while the nose will be clear, without discharge. But sometimes the discharge can be in the form of crumbly masses of a gray-dirty color.
In addition to the symptoms listed above, the patient may experience dizziness, headaches, when the mycetoma grows strongly, it occupies the entire volume of the maxillary sinus, creating excessive pressure, including in the eye sockets. And, of course, with a large proliferation of mycetoma of the maxillary sinus, sinusitis is possible.

The patient may have pain in the upper teeth in the posterior region from the side of the mycetoma. And, as I said earlier – difficulty in breathing, the patient’s transition to oral breathing as a result of acquired chronic sinusitis.

How extensive can a mycetoma be?

Molds can grow until the maxillary sinus is completely filled. And when the mold ball occupies the entire maxillary sinus (it usually takes 5-7 years to grow), then the diameter of the ball reaches an average of 3-5 centimeters.

For example, in front of you is a photo of a mycetoma of the maxillary sinus, when the growth of fungi almost completely “captured” it. The reason for the formation of mycetoma in this case was the part of the root filling of the tooth brought into the maxillary sinus:

How the root filling got into the maxillary sinus, we describe in detail in this clinical case.

What is the danger of fungus formation in the maxillary sinus

How can the growth of a fungal colony be dangerous? In any case, it is not very pleasant when any parasite, mold, fungus lives in you. This is a real parasite that lives in the cavity of the maxillary sinus and feels great there. In addition, mycetoma is dangerous in that the blood supply and oxygen supply to the brain deteriorates, since the nasal breathing function is disrupted. A person simply begins to experience partial oxygen starvation due to mycetoma.

Plus, the waste products of the fungus in the maxillary sinus drain into the nasopharynx, which can additionally lead to additional complications up to the development of allergies, provoking respiratory diseases. And, of course – sinusitis in a chronic form.

The role of CT in the study of mycetoma

Of course, a good CT scan gives a complete picture of the maxillary sinuses and is the main tool in the diagnosis of “mycetoma” when examining a patient. CT of the maxillary sinus shows the location, size, volume of mycetoma lesion (local volume or total damage to the cavity by the fungus).

In fact, computed tomography is the gold standard for diagnosing mycetoma today.

How can mycetoma be cured

Is it possible to do without surgery? Without surgical intervention, it is impossible to get rid of the fungus in the maxillary sinus, I will say this right away. No pills, no drops of “dance with a tambourine” and everything else will not give the proper therapeutic effect. First of all, it is necessary to surgically remove the fungal body, remove this mycelium, remove the entire fungus from the maxillary sinus.

This can be done either by nasal surgical access or by intraoral access.

How is the fungus removed from the maxillary sinus

With intraoral access, a perforation is made in the vestibular wall of the maxillary sinus – access, and evacuation occurs through this hole, i.e. removal of the fungal body, mushroom mycelium. Then the maxillary sinus is washed well, treated with antifungal and antimicrobial drugs and sutured. Subsequently, the patient is prescribed antifungal therapy.

Surgical removal of mycetoma shows good results to date, relapses are extremely rare.

Rehabilitation of the patient after removal of mycetoma

After surgical removal of the mycetoma, the patient’s rehabilitation period is from 3 to 5 days. And if we talk about post-surgical treatment, then it is longer, because after the removal of the mycetoma, it is necessary to continue to maintain antifungal therapy for several weeks.

Recommendations after removing the fungus from the maxillary sinus

It is necessary, first of all, to strictly follow the prescription of the attending physician, take the prescribed drug therapy, use special nasal antifungal drops. Secondly, the patient simply needs rest in order for the wound surface to heal normally.

There are no specific recommendations. In fact, everything is quite simple.

Dangerous mycetoma of the maxillary sinus – what is it, symptoms, treatment. German Implant Center, Moscow

Content:

1. What is a mycetoma?

2. Causes and features of the fungus

3. By what symptoms can mycetoma be detected?

4. Why is mycetoma dangerous?

5. How is mycetoma diagnosed?

6. Are we going to pick mushrooms? How is mycetoma treated?

Mycetoma is a fungal disease affecting the maxillary sinuses. Sometimes mycosis is called a fungal body. The disease is rare. The lesion spreads in one of the parts of the sinus.

Mycetoma: causes and features

The cause of the disease is often associated with dental treatment. A small part of the root filling enters the maxillary cavity. Around this inclusion, a fungal colony is formed , resembling wax or modeling clay in structure. The roots of the 5th and 6th teeth of the upper jaw are separated from the sinus only by a thin bone wall, and in some people by a mucous membrane.

The likelihood of colony growth increases when the composition of the filling material includes zinc, which acts as a catalyst for the reproduction of pathogenic microflora. An additional factor that increases the likelihood of the disease is reduced immunity as a result of the destructive effects of diabetes mellitus or the transferred courses of treatment with potent drugs. The body loses its ability to neutralize the fungus.

The growth of a colony can be accelerated by a microparticle of a fragment of a dental instrument that remains after the canal filling procedure by a low-skilled dentist or when using old treatment technologies. The mycelium fills the shell from the inside without growing into the mucous membrane. At first, this formation resembles a small ball, but then it increases, fills the space and remains in one of the parts of the sinus.

Symptoms of mycetoma

There are no pronounced symptoms with mycetoma. In the initial stages, the disease is rarely detected: the diagnosis is made as concomitant, accidentally detected during an examination prescribed for another purpose.

If the mycelium confidently expands the habitat and it becomes too much, then symptoms appear :

  • Nasal congestion on one side (where there is a lesion).