Invasive fungal sinusitis of isolated sphenoid sinus in immunocompetent subjects.
Invasive fungal sinusitis of the paranasal sinuses in a healthy immunocompetent person is uncommon. Isolated involvement of any paranasal sinus, particularly sphenoid sinus is rare. In this study, five immunocompetent patients who had no nasal complaints but obscure symptoms of headache and orbital symptoms such as diplopia, retro-orbital pain and loss of vision were diagnosed to be having fulminant fungal sinusitis of the sphenoid sinus. Three patients had aspergillosis and two patients had mucormycosis. These patients initially presented to neurologists and ophthalmologists because they had no ENT complaints. The diagnosis was made on endoscopy, radiology and histopathology. They were treated aggressively according to the standard protocols. The purpose of this paper is to bring to light the changing clinical spectrum of invasive fungal sinusitis. It can occur in immunocompetent patients and in the form of isolated sphenoid sinus involvement.
Chopra
Hemant
H
Department of ENT, Ludhiana, Punjab, India. hemantent23@rediffmail.com
Dua
Kapil
K
Malhotra
Vineeta
V
Gupta
Rishi Pal
RP
Puri
Harpreet
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy; D004172:Diplopia / Q000473:pathology; D004724:Endoscopy; D017809:Fatal Outcome; D005260:Female; D006261:Headache / Q000473:pathology; D006801:Humans; D007121:Immunocompetence; D008279:Magnetic Resonance Imaging; D008297:Male; D009091:Mucormycosis / Q000175:diagnosis* / Q000188:drug therapy; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders / Q000473:pathology
D000935:Antifungal Agents; D000666:Amphotericin B