Fulminant fungal sinusitis following intensive chemotherapy

Three cases of fulminant fungal sinusitis in patients undergoing intensive chemotherapy for haematological malignancies are described. Predisposing factors included courses of broad-spectrum antibiotics for febrile episodes. The presentation of sinusitis was acute, with facial pain and swelling, progressing to proptosis and visual disturbance. CT scanning is the investigation of choice to assess the extent of disease and subsequent response to treatment. Management requires urgent drainage, systemic and local antifungal therapy and decompressive procedures if necessary. Aggressive management can achieve good local control, but the long-term outlook remains poor.