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Chronic invasive Aspergillus Fumigatus rhinosinusitis with intracranial extension

Tobias Kremsmayer1, Nikita Rajbhandari2, Reed Jaworski1

  • 1University of Illinois Chicago College of Medicine, Chicago, USA.

Idcases
|June 8, 2026
PubMed

Insights

Diagnosing chronic invasive fungal rhinosinusitis caused by Aspergillus fumigatus is challenging. This case demonstrates disease progression despite extensive antifungal treatment, emphasizing the need for early, multidisciplinary intervention.

Area of Science:

  • Mycology
  • Neurology
  • Ophthalmology

Background:

  • Chronic invasive fungal rhinosinusitis (CIFRS) presents diagnostic challenges.
  • Invasive fungal infections can affect orbital and intracranial structures, particularly in immunocompromised individuals.

Purpose of the Study:

  • To highlight the diagnostic difficulties and poor prognosis associated with CIFRS.
  • To emphasize the importance of early, multidisciplinary intervention in managing complex fungal sinusitis cases.

Main Methods:

  • Case report of a 63-year-old male with type 2 diabetes mellitus.
  • Diagnostic evaluation included MRI, repeat biopsies, and DNA analysis.
  • Treatment involved intensive antifungal therapy (amphotericin, isavuconazole, micafungin).

Main Results:

  • DNA analysis confirmed Aspergillus fumigatus infection.
  • Disease progressed despite over a year of intensive antifungal treatment.
  • Patient experienced vision loss and brain abscess formation.

Conclusions:

  • Delayed diagnosis of CIFRS contributes to poor patient outcomes.
  • Surgical intervention was contraindicated due to morbidity concerns.
  • Early and multidisciplinary management is crucial for improving prognosis in invasive fungal sinusitis.
Keywords:
Antifungal medication therapyAspergillus fumigatusChronic invasive fungal disease with intracranial extensionType 2 diabetes mellitus

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