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Pansinusitis due to Sporothrix schenckii.
1Department of Microbiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Mycoses
|February 1, 2005
Summary
A rare case of mucocutaneous sporotrichosis caused pansinusitis with extensive spread in an Indian patient. Successful treatment involved antifungal medication and potassium iodide.
Area of Science:
- Mycology
- Infectious Diseases
- Otolaryngology
Background:
- Mucocutaneous sporotrichosis is a fungal infection typically affecting the skin and lymphatics.
- Pansinusitis with intracranial and intraorbital extension is a severe manifestation, rarely caused by Sporothrix schenckii.
Observation:
- A patient from Punjab, India, presented with a 12-year history of chronic nasal symptoms, including discharge, sneezing, and obstruction, with recurrent disease after endoscopic sinus surgery.
- Advanced imaging (CT and MRI) confirmed pansinusitis with significant intracranial and intraorbital extension.
Findings:
- Definitive diagnosis of sporotrichosis was confirmed through fungal culture identifying Sporothrix schenckii, verification of its dimorphic nature, and a positive pathogenicity test.
- The patient's condition demonstrated resistance to previous surgical interventions, highlighting the need for accurate etiological diagnosis.
Implications:
- This case underscores the importance of considering fungal infections like sporotrichosis in chronic, treatment-resistant sinonasal diseases, especially with unusual extensions.
- Successful treatment with a combination of potassium iodide and itraconazole offers a therapeutic strategy for this severe form of fungal sinusitis.