1 Introduction
Fungal sinusitis is inflammation of the mucosal lining of the paranasal
sinuses caused by fungal infection [1]. It is differentiated into
invasive and noninvasive fungal infections, with the former invading
epithelial cells and the latter usually limited to superficial
epithelial cells [2]. Immunocompromised and immunosuppressed
individuals are vulnerable to fungal sinusitis [3,4]. Fungal
sinusitis can also be classified into four types: acute (invasive),
chronic (invasive), fungal ball and allergic fungal sinusitis. The
pathological, immunological, and clinical features also vary among these
subtypes. Antibiotic consumption, corticosteroid therapy, and diabetes
mellitus are major predisposing factors for the development of fungal
sinusitis [5-7]. Fungal balls are usually noninvasive and might
become invasive if a patient is immunocompromised. The identification of
this condition relies primarily on clinical symptoms, endoscopic
findings, imaging studies, examination for pathogenic microorganisms,
and histopathological analysis. Surgical debridement, antifungal agents
and systemic factor treatment are regarded as therapeutic strategies
[8-10]. However, these treatment modalities face significant
challenges. Data have established that significant disease relapse
occurs even after surgical intervention [11,12]. In certain cases,
patients lose their vision even after aggressive surgical debridement
[13]. There is an inconsistency of evidence supporting antifungal
therapy for different subtypes of fungal sinusitis, and the risk of
antifungal sinusitis outweighs the benefit in the management of chronic
rhinosinusitis [14]. Current challenges in the treatment and
understanding of fungal sinusitis demand the development of potential
novel strategies [15-19]. In this regard, we present a case report
of fungal sinusitis successfully managed with standalone Ayurveda
treatment [20-22].