[Pseudotumoral naso-sinusal aspergillosis stabilized by itraconazole]

A 25 year-old non-immunocompromised African man showed a sino-orbital aspergillosis involving mostly the sphenoïd sinus, presenting as a growing tumour. Histopathologic study of the specimen biopsy revealed granulomata with intracellular septum branching hyphae. The electrosyneresis demonstrated serum antibodies to Aspergillus flavus. Initial treatment consisted of only surgical debridement in association of standard antifungal therapy (miconazole). After 14 months, a recurrence of the aspergillosis was stopped by the administration of itraconazole, an oral triazole antifungal. This treatment was performed during a period of 12 months and marked clinical improvement was observed. No adverse effects were noted. Itraconazole may be useful in therapy for extra-pulmonary aspergillosis when standard therapy has failed.