Fungal Sinusitis with Intracranial Extension in Immuno-competent Patients: Surgical Planning According to Relation to Eloquent Neurovascular Structures

Makhdoom, Naeem; Balkheur, Kamal; Foda, Montasser A. Abd-Elfattah; Fadel, Mamdouh M; Ahmad, Haroon; Othman, Hassan; Sheikh, Somaya Al

doi:10.1016/s1658-3612(08)70042-8

Cited by 5 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 20 The potential for observed intracerebral extension and comfort around the skull base highlights the need for interdisciplinary management teams that include neurosurgery and ear, nose, and throat (ENT) surgery to manage AFS patients with skull base invasion. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Chronic allergic fungal sinusitis invading the skull base in an immunocompetent male: illustrative case

Naik

Yang

Bellafiore³

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUNDAllergic fungal sinusitis (AFS) is an immunoglobulin E–mediated reaction to fungal organisms in the sinonasal region and can be categorized as acute or chronic. Acute infection is typical in immunocompromised patients, while chronic infection is classically seen in immunocompetent patients. Spread of infection to the skull base is a rare and potentially lethal complication of prolonged infection. Surgical management is frequently augmented with steroid therapy to prevent recurrence.OBSERVATIONSThe authors present a case of a 20-year-old African American male with prolonged headaches and blurred vision who was diagnosed with chronic invasive fungal sinusitis resulting in invasion of fungal burden into the anterior skull base and the posterior aspect of the clivus, in addition to complete obliteration of the maxillary sinus. The patient was managed surgically without complication and with gradual improvement in vision.LESSONSEarly management and detection of AFS should be a focus to prevent erosion of the fungal burden into the skull base. Neurosurgery and ear, nose, and throat surgery have a multidisciplinary role in the management of advanced AFS cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Chronic allergic fungal sinusitis invading the skull base in an immunocompetent male: illustrative case

Naik

Yang

Bellafiore³

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

show abstract

“…Some fungal species, such as Aspergillus spp., Cryptococcus spp. and Mucorales, etc., have been reported as the major pathogens involved in fungal CNS infections from sinusitis . On the other hand, filamentous basidiomycetes are recognised as extremely rare pathogens of CNS infections.…”

Section: Discussionmentioning

confidence: 99%

“…or Mucorales, have been reported. 2,3 However, CNS infections by filamentous basidiomycetes are extremely rare. Here, we report a case of epidural abscess due to the basidiomycetous fungus, Schizophyllum commune, extending from sinusitis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epidural abscess caused by Schizophyllum commune: A rare case of rhinogenic cranial complication by a filamentous basidiomycete

Tone

Fujisaki

Hagiwara

et al. 2017

Mycoses

View full text Add to dashboard Cite

Central nervous system (CNS) infections due to filamentous basidiomycetes are extremely rare. We encountered a case of epidural abscess due to Schizophyllum commune that extended from sinusitis. A 53-year-old Japanese man presented at our hospital with a headache. Computed tomography (CT) of the cranium and sinuses showed ethmoid and sphenoid sinusitis with no intracranial abnormalities. The patient was diagnosed with acute sinusitis and underwent antibiotic treatment. However, the symptoms deteriorated, and the patient came to our hospital again with consciousness disturbance. CT scan of the cranium and sinuses showed no improvement of sinusitis after antibiotic therapy and an epidural abscess emerged in the middle cranial fossa. Therefore, emergency craniotomy and endoscopic sinus fenestration were performed. Filamentous fungal elements were observed in both rhinorrhoea and epidural abscess. The symptoms improved after the operation and administration of liposomal amphotericin B. The clinical isolate was identified as S. commune by a molecular-based method. To our knowledge, this is the first report of epidural abscess due to this fungus. Although rare, clinicians should be aware that S. commune could be a causative agent of CNS infections.

show abstract

“…Although invasive fungal sinusitis has been increasingly reported due to increased survival of patients with various states of immunosuppression, it has been well known in immunocompetent individuals also. [15][16][17][18] A high index of suspicion, urgent imaging, and adequate biopsy led to the diagnosis of a well-known cause of visual loss, which is, however, unknown to cause altitudinal field defect. Our case demonstrates the role of an early neuroimaging in a patient with no remarkable history and clinical findings in preventing the visual loss.…”

Section: Discussionmentioning

confidence: 99%

Chronic Invasive Fungal Sinusitis Presenting as Inferior Altitudinal Visual Field Defect

Bansal

Takkar

Lal

et al. 2017

Neuro-Ophthalmology

View full text Add to dashboard Cite

A young male with acute blurring of vision (6/9) complained of an inferior altitudinal field defect in right eye. Clinical ophthalmological examination was normal. Magnetic resonance imaging (MRI) of the brain revealed the expansion and mucosal thickening of right posterior ethmoid and sphenoid sinuses and opacified right maxillary sinus. Surgical intervention (transethmoidal sphenoidotomy) and histopathological examination revealed chronic invasive granulomatous fungal sinusitis. Anti-fungal therapy led to resolution of visual complaints and restoration of visual field defects.

show abstract

Fungal Sinusitis with Intracranial Extension in Immuno-competent Patients: Surgical Planning According to Relation to Eloquent Neurovascular Structures

Cited by 5 publications

References 23 publications

Chronic allergic fungal sinusitis invading the skull base in an immunocompetent male: illustrative case

Chronic allergic fungal sinusitis invading the skull base in an immunocompetent male: illustrative case

Epidural abscess caused by Schizophyllum commune: A rare case of rhinogenic cranial complication by a filamentous basidiomycete

Chronic Invasive Fungal Sinusitis Presenting as Inferior Altitudinal Visual Field Defect

Contact Info

Product

Resources

About