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Invasive rhinosinusitis by Exserohilum rostratum in an immunocompetent child

Ayush Gupta1, Immaculata Xess, S C Sharma

  • 1Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.

BMJ Case Reports
|April 9, 2014
PubMed

Insights

Exserohilum rostratum, a fungal pathogen, can cause chronic invasive fungal rhinosinusitis, even in immunocompetent children. Early surgical intervention and antifungal treatment led to a successful outcome in this case.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Exserohilum species are known fungal pathogens causing severe infections, primarily in immunocompromised individuals.
  • Invasive fungal rhinosinusitis presents a significant challenge, often requiring aggressive management.

Observation:

  • A rare case of chronic invasive fungal rhinosinusitis with orbital involvement caused by Exserohilum rostratum is presented.
  • The affected individual was an immunocompetent child, highlighting a less common clinical presentation.

Findings:

  • The patient underwent successful endoscopic sinus surgery.
  • Treatment with oral itraconazole was initiated post-surgery.
  • The child demonstrated a positive response to the combined therapeutic approach.

Implications:

  • This case underscores the importance of considering Exserohilum infections in immunocompetent hosts presenting with complex sinonasal disease.
  • An aggressive surgical strategy is crucial for improving patient outcomes in invasive fungal infections.
  • Accurate microbiological diagnosis is essential for selecting appropriate systemic antifungal therapy in fungal rhinosinusitis.

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