In a 12-inch nonstick skillet, brown sausage over medium-high heat for 3-5 minutes. Transfer to a plate and keep warm.
In the same skillet, bring water to a boil. Add pasta, reduce heat, stir often until pasta is al dente, about 8-10 minutes. (Do not drain).
In a small bowl, whisk cornstarch, milk and hot pepper sauce. Gradually add to pasta; cook and stir until slightly thickened, about 2 minutes. Remove from heat; add cheese and sausage. Stir until blended and cheese melts. Sprinkle with crumbs if desired. Serve.
