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Atypical Pneumonia

Atypical Pneumonia

Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease...

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Chronic Invasive Fungal Sinusitis Mimicking Malignancy Post-Radiotherapy: A Case Report.

Aloysius W Y Lim¹, Tee Sin Lee¹, Jia Jia Wee¹

¹Department of Otorhinolaryngology and Head and Neck Surgery, Changi General Hospital, Singapore, 2 Simei Street 3, Singapore, 529889 Singapore.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India

|October 8, 2024

Summary

This summary is machine-generated.

Invasive fungal sinusitis can mimic cancer in patients previously treated with radiotherapy. This case highlights the diagnostic challenge, emphasizing that histopathology is key to distinguishing fungal infections from malignancy.

Keywords:

Aspergillosis Carcinoma Fungal sinusitis Radiotherapy Sarcoma

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Area of Science:

Otolaryngology
Pathology
Oncology

Background:

Invasive fungal sinusitis presents aggressively, often mimicking malignancy.
Distinguishing it from cancer is difficult, especially in post-radiotherapy patients due to potential recurrence or radiation-induced neoplasms.

Purpose of the Study:

To report a rare case of invasive fungal sinusitis mimicking malignancy in a patient with a history of nasopharyngeal carcinoma and radiotherapy.
To highlight diagnostic challenges in differentiating sino-nasal fungal infections from neoplastic processes in immunocompromised patients.

Main Methods:

Case report of a 68-year-old male, 25 years post-radiotherapy for nasopharyngeal carcinoma.
Clinical presentation included facial paresthesia and imaging showing a destructive mass.
Diagnosis confirmed via transpterygoid biopsy and histopathology identifying Aspergillus species.

Main Results:

Initial clinical and radiological findings suggested malignancy (nasopharyngeal carcinoma recurrence or radiation-induced sarcoma).
Histopathology revealed invasive fungal sinusitis caused by Aspergillus, with no evidence of malignancy.
The case underscores the potential for fungal sinusitis to present as a destructive mass mimicking cancer.

Conclusions:

Invasive fungal sinusitis can closely mimic neoplastic processes, particularly in post-radiotherapy cancer patients.
Histological examination with early fungal staining is crucial for accurate diagnosis.
Consideration of repeat investigations and re-evaluation is important, as coexisting malignancy is possible.