Chronic invasive aspergillosis of paranasal sinuses: A case report with review of literature

Abstract

Aspergillosis of the nasal and paranasal sinuses is recognized as being second to candidiasis, among opportunistic fungal infections in immunocompromised patients. However, invasive variant in normal and mildly immunocompromised hosts is a very rare occurrence. We report one such case of aspergillosis involving paranasal sinuses in mildly immunocompromised patient.

A Case Report of Maxillary Aspergillosis with Unusual Clinical and Imaging Presentations

“…Aspergillus is a fungus commonly found in humid areas and damp growing on decaying or decomposing matter. 3 The spores of this fungus are commonly inhaled and are usually found in the upper respiratory tract and lungs of primarily immunocompromised subjects. 3 There are reports, however, of the fungus causing destructive lesions in the paranasal sinuses of healthy adults.…”

“…3 The spores of this fungus are commonly inhaled and are usually found in the upper respiratory tract and lungs of primarily immunocompromised subjects. 3 There are reports, however, of the fungus causing destructive lesions in the paranasal sinuses of healthy adults. 3 The maxillary sinuses are the most commonly affected of all the paranasal sinuses.…”

“…3 There are reports, however, of the fungus causing destructive lesions in the paranasal sinuses of healthy adults. 3 The maxillary sinuses are the most commonly affected of all the paranasal sinuses. 4,5 Introduction into the maxillary antrum can sometimes occur at the time of a dental procedure such as extraction, root canal therapy, or placement of a dental implant.…”

“…4,5 The first report of aspergillosis in the maxillary sinus was made by Zarniko in 1891. 3 The mechanism by which sinus fungal infections cause destructive lesions are believed to be the induction of tissue necrosis. 3 Several predisposing factors have been suggested, including uncontrolled diabetes mellitus, inappropriate use of antibiotics, trauma, radiation therapy, and corticosteroid use.…”

“…3 The mechanism by which sinus fungal infections cause destructive lesions are believed to be the induction of tissue necrosis. 3 Several predisposing factors have been suggested, including uncontrolled diabetes mellitus, inappropriate use of antibiotics, trauma, radiation therapy, and corticosteroid use. 4 Clinical manifestations are usually ambiguous and range from nasal congestion and discharge to pain and headaches.…”