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Chronic invasive fungal sinusitis associated with intranasal drug use
Kelly R Pekala1, Matthew J Clavenna1, Ross Shockley1
1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
Abstract:
Chronic invasive fungal sinusitis (CIFS) is a rare but potentially aggressive form of invasive fungal disease that occurs in immunocompetent patients. We report a case of CIFS in an otherwise healthy young adult associated with intranasal illicit drug abuse. The patient presented with nonhealing nasal septal and palatal perforations. Biopsy demonstrated invasive Aspergillus flavus requiring surgical debridement and extended intravenous antifungal therapy. Tissue necrosis and ulceration related to intranasal drug use should be recognized as a potential risk factor for invasive fungal sinusitis.
Insights
Chronic invasive fungal sinusitis (CIFS) is a rare fungal infection. Intranasal drug abuse can be a risk factor for developing CIFS, even in healthy individuals.
Area of Science:
- Mycology
- Infectious Diseases
- Otolaryngology
Background:
- Chronic invasive fungal sinusitis (CIFS) is a rare, aggressive fungal infection.
- Typically affects immunocompetent individuals.
- Intranasal drug abuse is an emerging risk factor.
Observation:
- A case of CIFS in a young adult with a history of intranasal illicit drug abuse.
- Patient presented with nonhealing nasal septal and palatal perforations.
- Tissue necrosis and ulceration were noted.
Findings:
- Biopsy confirmed invasive Aspergillus flavus infection.
- Treatment required surgical debridement and prolonged intravenous antifungal therapy.
- Demonstrated a link between drug-induced tissue damage and fungal invasion.
Implications:
- Intranasal drug use should be considered a risk factor for CIFS.
- Early recognition of drug-related nasal/palatal lesions is crucial for timely diagnosis and treatment.
- Highlights the importance of considering non-traditional risk factors in invasive fungal diseases.