Prepare the pasta according to package instructions; drain.
In a Dutch oven, cook the sausage over medium heat for 6 to 8 minutes, until no longer pink. Break into smaller pieces while cooking. Spoon out fat and discard. Add garlic and cook for one more minute. Stir in the tomato paste. Stir in pureed tomatoes, Italian seasoning and red pepper flakes. Bring to a boil, and simmer 10 to 15 minutes, until slightly thickened.
Stir the cooked pasta into the sausage and tomato mixture. Stir in cream too. Heat a few minutes. Then stir in cheeses and place the lid on top to give the cheeses a chance to melt for a couple minutes.
Serve topped with fresh basil and additional Parmesan as desired.