Brief Answer:
Bact &
fungal sinusitis have diff picture on CT
Detailed Answer:
Hi,
Thanks for the query.
Bacterial and fungal sinusitis have different pictures usually on
CT scan.
Allergic fungal sinusitis is because of the reaction of the sinus mucosal lining to the fungal spore which enters that sinus. Usually body immunity makes that sinus to push out that fungus and restore the environment of the sinus. Sometimes that does not happen and an
allergic reaction ensues which leads to a fungal ball like formation in the sinus because of fungal elements and inspissated secretions. Superadded bacterial infection can occur in this environment.
The picture is characteristic on CT in most of the patients with hypo and hyperdense areas in the sinus.
The treatment for this is surgical and endoscopic debridement helps.
Bacterial sinusitis is due to bacterial infection in the
sinuses usually secondary to blockade in
drainage and ventilation of sinuses. This produces acute symptoms to start with and if treatment gives incomplete cure or if anatomical factors are there, the changes can become chronic.
Medical and surgical both treatments are required for this but decision to select the patient for
surgical treatment is to be taken by treating ENT based on CT findings, duration and frequency of symptoms and the severity of problem. Surgery is usually endoscopic.
A combination of both can be there in few patients.
Nasal irrigation post debridement helps in fungal sinusitis and not of much help otherwise in well established fungal disease.
Invasive fungal sinusitis can be there in immunocompromized patients and should be treated urgently.
Feel free to ask another query.
Regards