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Mold sinus infection = Allergic Fungal Sinusitis?

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!

 

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


Responses:

  1. What does a fungal ball look like and can you blow them out? I have a sinus infection but my snot looks like a “green bloody human brain” rather that traditional mucus. They come out half the size of a penny every 2-4 days.

    Comment by Lynette on December 29, 2019 at 1:37 am

  2. Hi Lynette, If are you still experiencing this issue, we would love to help you find out what is going on. Please give us a call 512-601-0303. Thanks

    Comment by Sinus & Snoring Specialists on September 21, 2020 at 8:46 pm

  3. THIS! Perhaps this is the cause of my extremely bad “advanced sinus disease”
    any treatment available in the 14216 zip code area?

    Comment by Colleen OMara on December 14, 2020 at 6:50 am

  4. No, I’m sorry. Our only location is in Austin, Texas

    Comment by Sinus & Snoring Specialists on January 21, 2021 at 3:52 pm

  5. Hello. My 13 year old son was diagnosed with AFS when he was 10. It is only in his right side. He has had FESS surgery on his right side and has been managing it since with mold immunotherapy shots (2 per month) and twice daily saline rinses and twice daily topical steroids sprays that range from Flonase Sensimist and or Xhance with occasional temporary steps up to Budesinide spray. He has had to take oral steroids (prednisone) once to eliminate a flare up (swelling / polyps). He gets a nasal scoping performed every 2 weeks to 3 months by his ENT specialist based on how he is doing. Will Dupixent eliminate the need for the topical steroids? Also would his mold shots suffice in lieu of the allergy drops? We live in the Dallas, Tx area.

    Thank you,
    Jim

    Comment by Jim Elliott on January 4, 2021 at 4:59 pm

  6. Hi Mr. Elliott, Sorry for the delay in responding to you. Dr. Slaughter would need to do an evaluation of your son to answer these questions and provide an appropriate treatment plan. Please give us a call at 512-601-0303 to schedule a consultation.

    Comment by Sinus & Snoring Specialists on February 25, 2021 at 7:45 pm

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