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Isolated invasive fungal sphenoid sinusitis-induced extensive bone erosion and severe meningoencephalitis: diagnosis

Bassel Hallak1, Pedro Teiga2, Abderrahmane Hedjoudje3

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Sion Hospital, Sion, Switzerland bassel.hallak@hopitalvs.ch.

BMJ Case Reports
|April 21, 2023
PubMed

Insights

Invasive fungal sinusitis (IFS) can affect immunocompetent individuals, posing a lethal risk. This case highlights aggressive Aspergillus fumigatus infection in the sphenoid sinus, leading to meningoencephalitis, emphasizing early diagnosis and multidisciplinary care.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Neurology

Background:

  • Invasive fungal sinusitis (IFS) is a severe condition, often seen in immunocompromised patients, but can occur in healthy individuals.
  • Non-invasive fungal sinusitis typically has a good prognosis, whereas IFS is potentially lethal.

Observation:

  • A case report details an immunocompetent woman in her 60s with an isolated Aspergillus fumigatus infection of the right sphenoid sinus.
  • The infection caused significant bone erosion of the sphenoid sinus walls and led to severe meningoencephalitis.

Findings:

  • Early diagnosis of sphenoid sinus pathologies is frequently delayed due to asymptomatic presentation.
  • Invasive fungal sinusitis of the sphenoid sinus is particularly aggressive and associated with high mortality rates.

Implications:

  • Aggressive and multidisciplinary treatment is crucial for reducing sequelae and improving survival in sphenoid sinus IFS.
  • Prompt diagnosis and intervention are vital for managing this severe form of fungal sinusitis.
Keywords:
Ear, nose and throatEpilepsy and seizuresInfectionsNeurology (drugs and medicines)Surgery

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