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Re: sinus

David Denning
April 16, 1999 09:46PM
I assume your immune function is ok and that you are not diabetic.
You most likely have a fungus ball which is probably due in part to abnormal anatomy of the nose and some predeliction of the fumigatus for you. If you have already had surgery to open up the sinuses, one problem is that the surgery did not deal with your ethmoid sinus air cells which can be infected and not effectively drained. Stammberger (find his paper in the database) uses endoscopy to deal with these problems and insists on drainage/destruction of teh ethmoid air cells to prevent recurrence.
Another possibility is that you have allergic aspergillus sinusitis. This might be helped by steroids - but i would caution against these unless the diagnosis is confirmed pathologically.
Finally you could have chronic invasive sinus aspergillosis, which is very difficult to eradicate. Long courses of itraconazole (and voriconazole) have a response rate of ~20%. Intravenous amphotericin B is the best approach, but this requires about 6-8 weeks daily therapy, and appropriate surgery.
So the key here is sorting out which disease you have getting the best treatment for that. Have you had your aspergillus antibodies measured? If positive, chronic invasive aspergillosis is more likely.
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> I found your site and wondered if you can recommend any therapies for fumigatus that I have in my sinus. I have been trying many many different approaches since 94. I have tried conventional anti fungals for long periods of time and have tried holistic avenues as well. Most things get rid of it, but it always comes back.
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> Thank you
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> David
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Subject Author Posted

sinus

David April 12, 1999 05:24PM

Re: sinus

David Denning April 16, 1999 09:46PM



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