title: Chronic invasive fungal sinusitis associated with intranasal drug use.
abstract: Chronic invasive fungal sinusitis (CIFS) is a rare but potentially aggressive form of invasive fungal disease that occurs in immunocompetent patients. We report a case of CIFS in an otherwise healthy young adult associated with intranasal illicit drug abuse. The patient presented with nonhealing nasal septal and palatal perforations. Biopsy demonstrated invasive Aspergillus flavus requiring surgical debridement and extended intravenous antifungal therapy. Tissue necrosis and ulceration related to intranasal drug use should be recognized as a potential risk factor for invasive fungal sinusitis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Pekala
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Clavenna
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
authors.forename: Ross
authors.initials: R
authors.lastname: Shockley
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
authors.forename: Vivian L
authors.initials: VL
authors.lastname: Weiss
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
authors.forename: Justin H
authors.initials: JH
authors.lastname: Turner
mesh_terms: D000281:Administration, Intranasal; D001228:Aspergillosis / Q000209:etiology*; D001231:Aspergillus flavus; D003646:Debridement; D006801:Humans; D008297:Male; D059747:Nasal Surgical Procedures / Q000379:methods; D012852:Sinusitis / Q000382:microbiology* / Q000601:surgery; D019966:Substance-Related Disorders / Q000150:complications*; D055815:Young Adult
keywords: Aspergillus; Invasive fungal sinusitis; Mucor; chronic granulomatous; cocaine; intranasal drug; invasive; perforation; sinusitis