Saprophytic Mycotic Infections of the Nose and Paranasal Sinuses

The kingdom of fungi is ubiquitous and omnipresent, having prevailed over the tides of time, over numerous decades by adapting to various methods of survival in the susceptible host including humans. Saprophytic fungi derive nutrition from dead and decaying organic matter, with the capacity to flare up in virulence, provided the right opportunity especially when the host immunity is compromised (as in prolonged steroid therapy, diabetes, HIV infection, tissue transplant recipients) or if there is a breech in a vital barrier permitting deeper tissue penetration (postsurgical or post-traumatic). Hence, knowledge about the saprophytic fungal elements dwelling within the nose and paranasal sinuses is paramount for Otolaryngologists worldwide, in order to accurately diagnose and effeciently manage such intriguing cases. This article provides a broad overview of the various opportunistic fungi in rhinology, and highlights the principles of diagnosis and protocols in management.