Dr. Grossman,

I have you seen you responding to many questions since i posted about
my question regarding "sinusitis and candida krusei" and its possible
role of hypogammaglobulinemia (cvid), lyme, etc.

over the post 5 weeks i have been having reoccuring bloody and green
discharge and am developing headaches as well as a feeling of cranial
neuritis.  i was coincidentally cultured for candida krusei at this
time by new pcp so i was wondering if that could be an active agent as
well.

can impacted sinuses, polyps, etc affect the cranial nerves?

i see my immunologist tommorow for a second visit and am seeing my pcp
next week before the holiday break.  i was thinking of asking him for a
ct of the paranasal sinuses and and then a refferal to an ENT that is
in his practice.

i would appreciate your expert opinion.  please read the post again.
if it is "over your head" don't be bashful in saying so.  i'm just
looking for some good advice not a hero (unless it's an italian hero).

what are your feelings on long term antifungal use?

much thanks...

zip

i found these articles on entrez pubmed if you can further extrapolate
on them that would be more than grateful.

Am J Ther. 1998 Mar;5(2):121-3.
Related Articles,  Links

1. Candida krusei sinusitis.

Alva EM, Khayr W.

Veterans Affairs Medical Center, Finch University of Health
Sciences/TheChicago Medical School, 3001 Green Bay Rd (111-I), North
Chicago, IL 60064, USA.

2. J Laryngol Otol. 1998 Jan;112(1):92-7.
Related Articles,  Links

Skull base osteitis following fungal sinusitis.

Swift AC, Denning DW.

Department of Otolaryngology, Aintree Hospitals Trust, Walton,
Liverpool.

Aspergillus sp. sinusitis is not uncommon in immunocompromised patients
but is unusual in patients who are not immunocompromised. The disease
may occur as a saprophytic condition, as an allergic sinusitis or as a
potentially lethal invasive disease. The differentiation between
non-invasive and invasive Aspergillus sp. sinusitis is crucial and this
distinction is fully discussed. The treatment options are also
considered. Invasive disease requires aggressive treatment with
long-term antifungal agents in sufficient doses combined with wide
surgical excision. We present a patient who presented with invasive
Aspergillus fumigatus sinusitis and subsequently developed cranial
neuropathies and skull base osteitis. She was initially treated with
oral itraconazole (400 mg daily) for 18 months but due to lack of
response this was changed to a new experimental oral azole
(voriconazole) which was continued for a further 14 months. She has
since remained well for the last five years.