Question

Classify fungal rhinosinusitis.

Hint:

In fungal rhinosinusitis, the classification depends on whether the infection is invasive or non-invasive, as well as the patient's immune status.

Answer 1

Step 1: Classification of Fungal Rhinosinusitis.
Fungal rhinosinusitis (FRS) is an infection of the paranasal sinuses caused by fungi. It can be classified into the following types based on the severity, the immune status of the patient, and the nature of the fungal infection:
(1) Non-Invasive Fungal Rhinosinusitis:
- Allergic Fungal Rhinosinusitis (AFRS): Characterized by the presence of fungal elements, such as fungal hyphae, in a patient with an allergic response. Common in individuals with a history of chronic rhinosinusitis.
- Chronic Fungal Rhinosinusitis: A low-grade infection in immunocompetent individuals, usually with non-invasive fungi like Aspergillus or Alternaria.
(2) Invasive Fungal Rhinosinusitis:
- Acute Invasive Fungal Rhinosinusitis (AIFRS): Rapidly progressive infection that can invade the sinuses and surrounding structures, often affecting immunocompromised patients (e.g., diabetics, transplant recipients).
- Chronic Invasive Fungal Rhinosinusitis: A slower, indolent infection, more common in immunocompromised individuals, often caused by fungi like Aspergillus or Mucor.
(3) Fungal Ball (Mycetom:
- A mass of fungal hyphae typically found in the maxillary sinus. It is non-invasive, and often presents with chronic sinusitis symptoms.