Invasive aspergillosis involving multiple paranasal sinuses--a case report

S Agarwal1, A Kanga, V Sharma

  • 1Department of Microbiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh - 171 001, India.

Insights

This case report details invasive fungal sinusitis caused by Aspergillus fumigatus in an immunocompetent patient. Surgical removal and antifungal medication successfully treated the paranasal sinus aspergillosis.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Invasive paranasal sinus aspergillosis (IPSA) is a rare fungal infection.
  • It typically affects immunocompromised individuals but can occur in immunocompetent hosts.
  • Early diagnosis and treatment are crucial to prevent complications.

Observation:

  • A young, immunocompetent woman presented with bilateral nasal obstruction.
  • Nasal polyps were identified, raising suspicion for a fungal etiology.
  • Radiological and histopathological examinations were performed.

Findings:

  • Diagnosis of invasive Aspergillus fumigatus infection was confirmed.
  • Microscopic examination revealed characteristic acute angle branching septate hyphae.
  • Fungal culture yielded Aspergillus fumigatus.

Implications:

  • This case highlights IPSA as a differential diagnosis in immunocompetent patients with sinonasal symptoms.
  • Aggressive surgical debridement combined with appropriate antifungal therapy (itraconazole) led to a favorable outcome.
  • Prompt diagnosis and management are essential for successful treatment of invasive fungal sinusitis.