About all

Mold in the sinuses. Chronic Illness and Mold Exposure: Unraveling the Connection to Naso-Sinus Fungal Biofilm

by alexxlab

How does mold exposure contribute to chronic illness. What role does naso-sinus fungal biofilm play in mold-related health issues. Can reducing fungal presence in the nose and air alleviate symptoms. How do mycotoxins affect neurological and immune systems. Are water-damaged buildings linked to respiratory problems and other health concerns.

Содержание

The Link Between Mold Exposure and Chronic Health Issues

Mold exposure has been increasingly recognized as a potential contributor to various chronic health conditions. Researchers have investigated the complex relationship between mold, mycotoxins, and human health, uncovering a range of associated symptoms and illnesses.

Dennis D.P. conducted a study in 2003 that explored the connection between chronic defective T-cells and fungal exposure. The research found that reducing fungi in the nose and air could potentially treat these immune system abnormalities, suggesting a direct link between mold exposure and immune function.

Dennis-Robertson Syndrome: A Unique Endocrine Disorder

In 2009, Dennis and colleagues identified a condition they termed “Dennis-Robertson syndrome.” This fungal exposure endocrinopathy is characterized by growth hormone deficiency, further highlighting the potential systemic effects of mold exposure on human health.

The Impact of Mycotoxins on Neurological and Immune Systems

Mycotoxins, toxic compounds produced by certain mold species, have been shown to have significant effects on both the neurological and immune systems in humans. Campbell et al. (2004) provided a comprehensive review of these effects, emphasizing the potential for long-term health consequences from mold exposure.

Neurobehavioral and Pulmonary Impairments

Kilburn’s 2009 study compared 105 adults exposed to indoor molds with 100 individuals exposed to chemicals. The findings revealed significant neurobehavioral and pulmonary impairments in the mold-exposed group, underscoring the potential severity of mold-related health issues.

  • Cognitive dysfunction
  • Memory problems
  • Mood disorders
  • Respiratory difficulties

Water-Damaged Buildings and Health Risks

Several studies have investigated the health risks associated with occupancy in water-damaged buildings. These environments often harbor elevated levels of mold and mycotoxins, leading to a range of health concerns for inhabitants.

Respiratory Tract Infections and Asthma

A meta-analysis by Fisk et al. (2010) found a significant association between residential dampness and mold with respiratory tract infections and bronchitis. Additionally, Park et al. (2012) identified rhinosinusitis and mold as risk factors for asthma symptoms in occupants of a water-damaged building.

Sarcoidosis and Mold Exposure: An Emerging Connection

Recent research has suggested a potential link between mold exposure and sarcoidosis, an inflammatory disease characterized by the formation of granulomas in various organs. Tercelj et al. (2011) conducted an environmental exposure study that found increased fungal presence in the homes of patients with sarcoidosis.

Occupational Exposure and Sarcoidosis Risk

Laney et al. (2009) investigated the prevalence of sarcoidosis, asthma, and asthma-like symptoms among occupants of a historically water-damaged office building. Their findings suggested an increased risk of these conditions in such environments, further supporting the connection between mold exposure and respiratory health issues.

Chronic Fatigue Syndrome and Mold-Related Illness

The relationship between mold exposure and chronic fatigue syndrome (CFS) has been a subject of increasing interest in recent years. Brewer et al. (2013) detected mycotoxins in patients with CFS, suggesting a potential etiological link between mold exposure and this debilitating condition.

Sick Building Syndrome and CFS: Overlapping Symptoms

Chester and Levine (1994) revisited the concept of epidemic neuromyasthenia, exploring the concurrent presentation of sick building syndrome and chronic fatigue syndrome. This overlap in symptoms highlights the complex nature of mold-related illnesses and the challenges in diagnosis and treatment.

Mycotoxins in Indoor Environments: Detection and Health Implications

The presence of mycotoxins in indoor environments, particularly in water-damaged buildings, has been well-documented. Polizzi et al. (2009) conducted a comprehensive study on fungi, mycotoxins, and microbial volatile organic compounds in moldy interiors, providing valuable insights into the potential health risks associated with these contaminants.

Trichothecene Mycotoxins in Ventilation Systems

Smoragiewicz et al. (1993) detected trichothecene mycotoxins in the dust of ventilation systems in office buildings, highlighting the potential for widespread exposure through building infrastructure. This finding emphasizes the importance of regular maintenance and inspection of ventilation systems in preventing mold-related health issues.

Naso-Sinus Fungal Biofilm: A Potential Culprit in Chronic Illness

While the original text does not explicitly discuss naso-sinus fungal biofilm, the research presented suggests that fungal colonization of the nasal passages and sinuses may play a significant role in mold-related chronic illnesses. The study by Dennis (2003) on reducing fungi in the nose and air to treat chronic defective T-cells supports this hypothesis.

Potential Mechanisms of Naso-Sinus Fungal Biofilm in Chronic Illness

Naso-sinus fungal biofilm could contribute to chronic illness through several mechanisms:

  1. Persistent local inflammation
  2. Continuous release of mycotoxins
  3. Disruption of normal sinus function
  4. Immune system dysregulation
  5. Neurological effects due to proximity to the brain

Further research is needed to fully elucidate the role of naso-sinus fungal biofilm in mold-related chronic illnesses and to develop targeted treatment strategies.

Prevention and Remediation Strategies for Mold-Related Health Issues

Given the potential health risks associated with mold exposure, prevention and remediation strategies are crucial for maintaining a healthy indoor environment. These strategies may include:

  • Regular inspection and maintenance of buildings
  • Prompt repair of water damage
  • Proper ventilation and humidity control
  • Use of air filtration systems
  • Professional mold remediation when necessary

Additionally, individuals experiencing symptoms potentially related to mold exposure should seek medical attention and consider environmental testing to identify and address any sources of mold contamination.

Holistic Approaches to Treating Mold-Related Illnesses

Treatment of mold-related illnesses often requires a multifaceted approach, addressing both the environmental factors and the individual’s health. This may include:

  • Removal from the mold-contaminated environment
  • Detoxification protocols
  • Immune system support
  • Targeted treatments for specific symptoms
  • Nutritional interventions
  • Stress reduction techniques

Healthcare providers specializing in environmental medicine may be best equipped to develop comprehensive treatment plans for individuals affected by mold-related chronic illnesses.

Future Directions in Mold-Related Health Research

As our understanding of the health impacts of mold exposure continues to evolve, several areas of research warrant further investigation:

  1. The specific mechanisms by which mycotoxins affect human health
  2. The role of genetic susceptibility in mold-related illnesses
  3. Development of more sensitive and specific diagnostic tools
  4. Evaluation of long-term health outcomes following mold exposure
  5. Investigation of potential therapeutic interventions targeting naso-sinus fungal biofilm

Continued research in these areas will be crucial for improving our ability to prevent, diagnose, and treat mold-related chronic illnesses effectively.

Interdisciplinary Collaboration in Mold-Related Health Research

The complex nature of mold-related health issues necessitates an interdisciplinary approach to research and treatment. Collaboration between various fields, including:

  • Environmental science
  • Immunology
  • Neurology
  • Microbiology
  • Toxicology
  • Clinical medicine

This collaborative effort will be essential for developing a comprehensive understanding of the relationship between mold exposure and chronic illness, as well as for creating effective prevention and treatment strategies.

The Economic Impact of Mold-Related Chronic Illnesses

The prevalence of mold-related chronic illnesses has significant economic implications, both for individuals and society as a whole. These costs may include:

  • Direct medical expenses
  • Lost productivity due to illness
  • Costs associated with building remediation
  • Legal expenses related to mold exposure claims
  • Reduced property values in affected areas

Quantifying these economic impacts is challenging due to the complex nature of mold-related illnesses and the variability in individual responses to exposure. However, understanding the economic burden of these conditions is crucial for informing public health policies and prioritizing research efforts.

Cost-Benefit Analysis of Mold Prevention Strategies

Implementing effective mold prevention strategies may require significant upfront investment, particularly in large-scale building projects or renovations. However, the long-term benefits of these measures, including reduced healthcare costs and improved productivity, likely outweigh the initial expenses.

Future research should focus on conducting comprehensive cost-benefit analyses of various mold prevention and remediation strategies to guide decision-making in both public and private sectors.

Public Health Implications and Policy Considerations

The growing body of evidence linking mold exposure to chronic health issues has important implications for public health policy. Key considerations include:

  1. Updating building codes and regulations to prioritize mold prevention
  2. Developing standardized protocols for assessing and remediating mold-contaminated environments
  3. Implementing public education campaigns on the health risks associated with mold exposure
  4. Establishing guidelines for healthcare providers in diagnosing and treating mold-related illnesses
  5. Allocating resources for research into mold-related health issues and potential interventions

Policymakers and public health officials must work together to address these challenges and protect vulnerable populations from the health risks associated with mold exposure.

Environmental Justice and Mold Exposure

It is important to recognize that the burden of mold-related health issues is not equally distributed across populations. Factors such as socioeconomic status, housing quality, and access to healthcare can significantly influence an individual’s risk of mold exposure and their ability to address related health concerns.

Addressing these disparities should be a key consideration in developing public health policies and interventions related to mold exposure and chronic illness. This may include targeted outreach and support for vulnerable communities, as well as efforts to improve housing conditions and environmental health in underserved areas.

The Role of Technology in Addressing Mold-Related Health Issues

Advancements in technology offer promising solutions for addressing mold-related health issues. Some potential applications include:

  • Improved sensors for early detection of moisture and mold growth
  • Advanced air filtration and purification systems
  • Machine learning algorithms for predicting mold growth patterns
  • Telemedicine platforms for remote consultation with environmental health specialists
  • Wearable devices for monitoring individual exposure to mold and mycotoxins

Integrating these technologies into mold prevention, detection, and treatment strategies could significantly improve outcomes for individuals at risk of mold-related chronic illnesses.

Challenges in Implementing Technological Solutions

While technology offers promising solutions, several challenges must be addressed to ensure effective implementation:

  1. Cost and accessibility of advanced detection and remediation technologies
  2. Integration of new technologies with existing building systems and healthcare practices
  3. Privacy concerns related to monitoring and data collection
  4. Ensuring the reliability and accuracy of technological solutions
  5. Training and education for professionals in using new technologies

Overcoming these challenges will require collaboration between technology developers, healthcare providers, building professionals, and policymakers to create comprehensive and effective solutions for addressing mold-related health issues.

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).