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Unusual presentation of entomophthoromycosis

R C Michael1, J S Michael, M S Mathews

  • 1Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India. rajmike@hotmail.co.uk

Indian Journal of Medical Microbiology
|April 23, 2009
PubMed

Insights

This case report details rhinoentomophthoromycosis caused by Conidiobolus sp in an 18-year-old Indian girl, complicated by pulmonary tuberculosis. The study highlights the challenges in managing this rare fungal infection affecting the sinuses and orbits.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Rhinoentomophthoromycosis, a fungal infection caused by Conidiobolus species, typically manifests as chronic granulomatous lesions in the rhinofacial subcutaneous tissue.
  • Orbital involvement and vision loss are rare but severe complications of Conidiobolus infections.

Observation:

  • An 18-year-old female presented with rapidly progressing bilateral proptosis and vision loss.
  • Fungal cultures and biopsy confirmed Conidiobolus sp infection of the paranasal sinuses with orbital extension, leading to blindness.
  • The patient was concurrently diagnosed with sputum-positive cavitatory pulmonary tuberculosis.

Findings:

  • This represents the first reported case of rhinoentomophthoromycosis with orbital extension and concurrent pulmonary tuberculosis from India.
  • The diagnosis was confirmed through histopathological examination and fungal cultures.
  • The patient experienced irreversible vision loss due to the extensive orbital fungal infection.

Implications:

  • This case underscores the aggressive potential of Conidiobolus sp infections, particularly with orbital invasion.
  • Co-infection with tuberculosis presents a significant management challenge, requiring simultaneous treatment of both conditions.
  • There is no established consensus on the optimal antifungal treatment for Conidiobolus infections of the sinuses and orbits, necessitating further research.

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