Isolated Fungal Sphenoid Sinusitis With Cavernous Sinus Thrombophlebitis: A Case Report

Area of Science:

• Ophthalmology
• Infectious Diseases
• Neurology

Background:

• Cavernous sinus thrombophlebitis (CST) is a rare, life-threatening condition often caused by bacterial or fungal infections.
• Mucor species are opportunistic fungi typically affecting immunocompromised individuals.

Observation:

• This report details a unique case of an immunocompetent adult female who developed CST secondary to Mucor sphenoid sinusitis.
• The patient presented with classic symptoms including headache, diplopia, and abducens nerve palsy.

Findings:

• Cranial MRI revealed bilateral CST and extensive sphenoid sinus secretions.
• Fungal cultures confirmed Mucor infection. Treatment involved anticoagulation, antibiotics, endoscopic sinus surgery, and antifungal therapy (itraconazole).
• The patient achieved complete clinical and radiological recovery without neurological deficits.

Implications:

• This case highlights that Mucor sphenoid sinusitis can cause CST even in immunocompetent individuals.
• It underscores the importance of considering fungal sinusitis in the differential diagnosis of CST.
• Early diagnosis and multidisciplinary management are crucial for favorable outcomes in this rare condition.