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Paecilomyces fungus infection of the paranasal sinuses
D R Nayak1, R Balakrishnan, S Nainani
1Department of Otolaryngology, Kasturba Medical College and Hospital, Manipal-576 119, Karnataka, India. info@mahe.ernet.in
Abstract:
Fungal infections caused by Paecilomyces species are very rare and occur in adult patients with impaired host defences or following foreign body implants. They are found worldwide in soil and decaying vegetation. We describe a case of an 8 year old child who came with complaints of left sided nasal obstruction and discharge, telecanthus, diplopia and epiphora. On examination and investigation he had pansinusitis caused by P. lilacinus. An endoscopic sinus surgery was done and the patient was on oral Itraconazole for 6 months. To our knowledge, this is the first case reported in the paediatric age group.
Insights
Paecilomyces lilacinus fungal infections are rare, especially in children. This case highlights a rare pediatric pansinusitis caused by P. lilacinus, successfully treated with surgery and antifungal medication.
Area of Science:
- Mycology
- Pediatric Infectious Diseases
- Otolaryngology
Background:
- Fungal infections by Paecilomyces species are uncommon, typically affecting immunocompromised adults or those with foreign body implants.
- Paecilomyces species are ubiquitous fungi found in soil and decaying organic matter worldwide.
Observation:
- An 8-year-old child presented with unilateral nasal obstruction, discharge, telecanthus, diplopia, and epiphora.
- Clinical examination and investigations revealed pansinusitis.
Findings:
- The pansinusitis was diagnosed to be caused by Paecilomyces lilacinus.
- The child underwent endoscopic sinus surgery and received a 6-month course of oral Itraconazole.
Implications:
- This is the first reported case of Paecilomyces lilacinus-induced pansinusitis in a pediatric patient.
- The case underscores the importance of considering rare fungal pathogens in pediatric sinonasal infections, even in immunocompetent children.