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Exophiala oligosperma involved in a refractory chronic rhinosinusitis

H Badali1, M T Hedayati, M Bahoosh

  • 1Department of Medical Mycology and Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

European Review for Medical and Pharmacological Sciences
|May 3, 2011
PubMed

Insights

A rare black yeast, Exophiala oligosperma, caused a sinus fungus ball in a patient with chronic rhinosinusitis. Successful treatment was achieved with surgery and corticosteroid nasal spray, avoiding antifungal drugs.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Fungal rhinosinusitis encompasses diverse conditions arising from fungal infections in the paranasal sinuses.
  • While Aspergillus species are common, melanized fungi can cause severe, even fatal, complications.
  • Allergic fungal rhinosinusitis and sinus fungus balls typically affect immunocompetent individuals.

Observation:

  • This report details a unique case of a fungus ball in a 20-year-old female experiencing refractory chronic rhinosinusitis and bronchial asthma.
  • The causative agent was identified as the black yeast Exophiala oligosperma through mycological and molecular analysis (ITS rDNA sequencing).
  • This marks the first documented instance of Exophiala oligosperma causing fungus balls or invasive fungal rhinosinusitis.

Findings:

  • Surgical removal of hypertrophic mucosa via functional endoscopic sinusitis surgery was performed.
  • The patient achieved a successful clinical cure without antifungal medication, utilizing corticosteroid nasal spray therapy for one month.
  • A six-month follow-up revealed no relapse of the condition.

Implications:

  • This case expands the known spectrum of fungal pathogens implicated in rhinosinusitis.
  • It highlights the potential for Exophiala oligosperma to cause sinus disease.
  • The successful non-antifungal treatment approach offers a potential alternative for managing similar cases, emphasizing the role of surgical intervention and corticosteroid therapy.

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