Brief Answer:
I would not suggest you any anti-fungal medicines at present...

Detailed Answer:
Hello Mr. XXXXXXX

Thanks for posting the query. I have gone through your query thoroughly and understood your problem. I will try my best to help you.

1. Your CT scan and blood reports are normal, but, your nasal culture reports say that you are having fungal elements. So, it implies that you are having a very mild variety of Allergic Fungal Sinusitis. Also, your CT scan report says the sinuses are normal; I would not suggest you any antifungal medicines at present.

2. The treatment protocol for Allergic Fungal Sinusitis without any complications include:
a. Intranasal Steroid Nasal Spray such as Fluticasone or Mometasone.
b. Saline Nasal Douching regularly.
c. A short course of oral corticosteroids.
d. An antihistamine such as Fexofenadine or Loratidine.
e. Immunotherapy, if available at your place.

3. Antifungal medications are prescribed for much severe cases. Yours is a mild case of Allergic Fungal Sinusitis, hence, I would not recommend any Antifungal medications at this juncture.

Hope this answers your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

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Brief Answer:
No, steroid sprays are not going to increase the fungal growth...

Detailed Answer:
Welcome back Mr. XXXXXXX

1. I wasn't able to see the attached report as it is not opening on my dashboard, but, I went by your words. The above fungus is of the least harmful variety, hence, we don't treat your condition aggressively.

2. There are two schools of thought, one says there may be some benefit with antifungal medications, but, the other researchers say that it is not helpful in eradicating the mild Allergic Fungal Sinusitis.

3. With adequate nasal douching using normal saline and proper medications I mentioned above, your problems could be solved. I have been treating the mild cases of Allergic Fungal Sinusitis with the above-mentioned method and I see a remarkable improvement in their symptoms and signs.

4. Oral antifungal medications are more harmful to the liver, hence, we use it very judiciously.

Hope this clarifies your doubts; wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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