Rhinomycosis

Rhinomycosis is a disease caused by fungal infections in the nasal cavity and sinuses. The pathogenic
bacteria include Aspergillus, Mucor and Candida. Long-term use of antibiotics, adrenocortical
hormones, immunosuppressants, chemotherapy and radiotherapy, diabetes, uremia, acidosis, leukemia,
severe anemia, severe burns and other factors that reduce the body's resistance, and deviated nasal
septum, nasal polyps, infectious or allergic When the rhinitis, sinusitis, etc. cause mechanical blockage
of the nasal cavity and sinuses, it is easy to cause fungal infection and the disease.

Rhinomycosis disease name

Rhinomycosis

Overview of rhinomycosis diseases

Rhinomycosis can be classified clinically into four types based on its symptoms:(1) Non-invasive : It is
common in patients without immunodeficiency, and it occurs in the maxillary sinus and nasal cavity.
Patients have symptoms such as nasal congestion, purulent snot, blood in the snot, headache, etc., and
they are ineffective in antibacterial treatment and repeated sinus irrigation.(2) Invasive type : It is
common in patients with immunodeficiency and the clinical manifestations are invasive infection. In
the early stage, there were only slight symptoms of sinusitis. Necrosis and scabs were often found in the
front of the nasal cavity. The necrotic site could spread to the outer wall of the nasal cavity after a few
days, and symptoms and signs of malignant disease gradually appeared. Patients may have fever, strong
symptoms, or even coma and die. Rhinomycosis can also cause visceral infections.(3) Aspergilloma
type : The disease course is slow, granulation tissue and purulent secretions are found in the maxillary
sinus and ethmoid sinus, and facial soft tissues are raised. Sinus radiographs showed bone destruction,
but no cancer cells were found on biopsy.(4) Allergic type : common in young people with a history of
asthma and nasal polyps. Rhinomycosis is mainly diagnosed from clinical symptoms, X-ray film or CT
scan, fungal culture, and pathological examination. The main treatment of this disease is
surgery.Disease Classification: Otolaryngology Disease Description Rhinomycosis is a specific
infectious disease common in rhinology.

Rhinomycosis symptoms and signs

1. Non-invasivePatients have a stuffy nose, runny nose, sometimes bloody nose, and headache. X-ray
film of the sinuses showed that the shadow of the sinus cavity on the affected side was blurred, similar
to general chronic sinusitis, and the systemic symptoms were not significant.2. InvasiveNecrosis and
crusting often occur in the front of the patient's nasal cavity; the necrotic site can spread to the outer
wall of the nasal cavity after a few days, and there can be exophthalmos, conjunctival hyperemia, ocular
muscle paralysis, vision loss, and posterior orbital pain. In the end, there may be fever and Xiangqi until
coma and death. The liver, spleen, and lungs can also be affected by fungi.3.Aspergilloma typeThe
course of disease is slow, with granulation tissue and purulent secretions in the maxillary and ethmoid
sinuses, and facial soft tissues bulge. Sinus radiographs showed bone destruction, but no cancer cells
were found on biopsy.4.AllergicMore common in young people, often with a history of nasal polyps
and asthma. Despite repeated sinus surgery, sinusitis still recurs. X-ray examination showed multiple
sinus or total sinus involvement, and increased sinus cavity density. Serological examination showed
that the Aspergillus fumigatus precipitin test was positive.

Causes of Rhinomycosis
 The pathogenic fungi of rhinomycosis include Aspergillus, Candida and Mucor. It is often caused by
the long-term use of antibiotics, steroid hormones, immunosuppressive agents or cancer radiation
therapy, diabetes, burns, etc. Consumption of antibiotics, steroid hormones, immunosuppressive agents,
or cancer radiation therapy, diabetes, burns, etc. decrease of resistance. The unintentional discovery of
nasal mycosis in healthy human examinations in recent years may be related to the widespread
development of medical examinations and the increasing attention to the disease. Although nasal-brain
mucormycosis is rare, it has a high mortality rate, so it is also valued by scholars. RhinoAspergillosis is
more common.

Rhinomycosis pathophysiology
Nasal mycosis can be divided into four types: non-invasive, invasive (fulminant), aspergilloma, and
allergic. Non-invasive lesions are usually limited to the maxillary sinus mucosa. Invasive lesions are
caused by fungal invasion of the mucosa and cause thrombotic arteritis, causing necrosis of the sinus
mucosa and bone wall. In severe cases, they can spread to the orbit, pterygopalatine fossa, and even the
anterior cranial fossa. The lesions have bloody pus, granulation, necrotic tissue, and dry-like (nasal-
brain type) Mucor lesions similar to this, but more severe, with a poor prognosis). Allergic granuloma
in the sinus has most eosinophils, free eosinophils, Charcot-leyden crystals, and fungal hyphae.

Rhinomycosis diagnosis test

Pathological examination: The secretion was taken and cultured in Sabouraud medium for 1-2 days, and
the hyphae of Aspergillus spp. Could be seen. The separated bifurcated hyphae can be identified under
the light microscope, which can be used for diagnosis. Biopsy of the diseased tissue showed thrombosis
in the arterioles and Aspergillus mycelium on the mucosal surface. Sinus radiographs showed bone
destruction.

Rhinomycosis treatment options

Non-invasive and aspergilloma should be treated with sinus cleansing to remove the diseased tissues
and secretions in the nasal cavity and sinuses, and the prognosis is better. Invasive patients must use
antifungal drugs such as amphotericin B, clotrimazole, nystatin, flucytosine, and intermittent oxygen
inhalation before and after surgery. During treatment, antibiotics and immunosuppressants must be
stopped and attention should be paid to improve the general condition.

Rhinomycosis safety tips

Long-term use of antibiotics, adrenocortical hormones, immunosuppressants, chemotherapy and radiotherapy,
diabetes, uremia, acidosis, leukemia, severe anemia, severe burns and other factors that reduce the body's
resistance, and deviated nasal septum, nasal polyps, infectious or allergic When the rhinitis, sinusitis, etc. cause
mechanical blockage of the nasal cavity and sinuses, it is easy to cause fungal infection and the disease.(1)
Non-invasive : It is common in patients without immunodeficiency, and it occurs in the maxillary sinus and
nasal cavity. Patients have symptoms such as nasal congestion, purulent snot, blood in the snot, headache, etc.,
and they are ineffective in antibacterial treatment and repeated sinus irrigation. If secondary bacterial or viral
infections occur, symptoms of acute sinus inflammation can also occur. Anterior rhinoscopy showed that the
nasal mucosa was covered with gray or black pseudomembrane, accompanied by empyema; the maxillary
sinus was punctured with purulent secretions and massive dregs. X-ray film of the sinuses showed that the
shadow of the sinus cavity on the affected side was blurred, but there was no bone destruction. Systemic
symptoms are not obvious.(2) Invasive type: It is common in patients with immunodeficiency and the clinical
manifestations are invasive infection. There are only mild symptoms of sinusitis in the early stage, and there is
often necrosis and crusting in the front of the nasal cavity; the necrotic site can spread to the outer wall of the
nasal cavity after a few days, and symptoms and signs of malignant diseases such as facial pain, local swelling,
protruding eyes, conjunctival congestion, Ophthalmoplegia, vision loss, and posterior orbital pain; meningitis
and brain abscess may eventually appear. Patients may have fever, strong symptoms, or even coma and die.
Nasal mycosis can also cause visceral infections of the liver, spleen, and lungs.(3) Aspergilloma type : The
disease course is slow, granulation tissue and purulent secretions are found in the maxillary sinus and ethmoid
sinus, and facial soft tissues are raised. Sinus radiographs showed bone destruction, but no cancer cells were
found on biopsy.(4) Allergic type : common in young people with a history of asthma and nasal polyps.
Despite repeated sinus surgery, sinusitis still recurs. X-ray sinus radiographs showed that multiple sinuses or
whole sinuses were filled with thick, concentrated mucus, and the density of the sinus cavity increased, but no
bone and soft tissue invasion. Serological examination showed that the Aspergillus fumigatus precipitin test
was positive.