Paranasal sinus fungus balls.
BACKGROUND
Paranasal sinus fungus balls (mycetomas) are a form of fungal sinus infection distinct from allergic fungal sinusitis, fulminant invasive fungal disease, and paranasal aspergillus granulomas.


METHODS
The Mayo Clinic surgical pathology files of inflammatory sinus specimens from 1984 to 1994 were examined. Twenty-nine paranasal sinus fungus balls were identified. Cases of allergic fungal sinus and invasive fungal disease were excluded.


RESULTS
The fungus ball occurred in 11 men and 18 women, with an age range of 28 to 86 years, mean 64 years. Sinuses involved included maxillary (20 cases), sphenoid (10 cases), ethmoid (9 cases), and frontal (6 cases). In 12 patients, multiple sinuses were involved in a variety of combinations. By culture the most common pathogens were Aspergillus fumigatus and Aspergillus flavus. Treatment was by a variety of surgical procedures. Follow-up in 28 patients showed two recurrences and three deaths due to intracerebral bleed as a complication of surgery. These deaths occurred in patients with sphenoid sinus fungus balls.


CONCLUSIONS
Paranasal sinus fungus balls occurs in an elderly population and have a female predominance. They have a low morbidity and recurrence rate. Death can occur in sphenoid sinus lesions as a complication of surgery.
Ferreiro
J A
JA
Department of Laboratory Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Carlson
B A
BA
Cody
D T
DT
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000473:pathology / Q000601:surgery; D001231:Aspergillus flavus / Q000302:isolation & purification; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000209:etiology; D015521:Ethmoid Sinusitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015522:Frontal Sinusitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D008271:Mycetoma / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications; D012008:Recurrence; D012737:Sex Factors; D012852:Sinusitis / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000382:microbiology / Q000473:pathology / Q000601:surgery