Phaeohyphomycosis of the paranasal sinuses masquerading as a neoplasm: A case report

Mehta, Samir A.; Kaul, Shibban K; Mehta, Mona S.; Kelkar, Rohini; Mehta, Ashok

doi:10.1002/hed.2880150113

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…In the present review the average patient age was younger— 23.3 years (mean, 21.9 y) (Table II). Ages ranged from a low of 7 years 5 to a high of 62 years 12 . Also, in reviewing cases that indicated sex, a male predominance with a male‐to‐female ratio of 1.6 was noted.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Bipolaris-coupled disks were then added to each tube for 12 to 16 hours. The disks were then washed three times with PBS-Tween and subsequently incubated with 1125-radiolabeled antihuman IgE (Pharmacia and Upjohn [Kalamazoo, MI], approximately 30,000 cpm) for another 12 hours. The disks were then washed again and a gamma scintillation counter was used to measure radiation.…”

Section: Rast Inhibition For Bipolaris-specific Igementioning

confidence: 99%

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Further evidence for allergic pathophysiology in allergic fungal sinusitis

1998

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Controversy continues over whether allergic fungal sinusitis represents a true allergy, an infection, or a point somewhere along a spectrum between allergy and infection. The present study describes two experiments that add weight to the argument that allergic fungal sinusitis (AFS) is truly an immunologically mediated hypersensitivity and not a form of infection. In the first experiment, eight patients with Bipolaris culture-positive AFS were prospectively evaluated with Bipolaris antigen skin testing and with inhibition radioallergosorbent (RAST) and enzyme-linked immunosorbent assay (ELISA) for Bipolaris-specific IgE and IgG antibodies. The Bipolaris AFS cases were compared with 10 control patients with no history of AFS. All eight AFS cases demonstrated positive skin testing to Bipolaris and in addition, all tested positive by RAST and ELISA for IgE and IgG Bipolaris antibodies, respectively. In the control group one patient had a positive skin test, ELISA, and RAST and one additional patient had a positive ELISA only. Good correlation was noted between skin test, RAST, and ELISA results. In the second experiment, sinus mucosa from 14 AFS patients and 10 control patients with other forms of surgical sinus disease was analyzed by immunohistocytochemistry for the eosinophilic inflammatory mediators major basic protein (MBP) and eosinophil derived neurotoxin (EDN) and the neutrophil mediator neutrophil elastase. All AFS cases demonstrated evidence of eosinophilic mediator release, and MBP and EDN predominated over neutrophil elastase. In the control group eosinophil and neutrophil mediator release in sinus mucosa was equal. The two experiments support the concept that AFS is an antigen-triggered, IgE- and IgG-mediated hypersensitivity response with a late-phase inflammatory reaction involving release of eosinophilic mediators.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Rast Inhibition For Bipolaris-specific Igementioning

confidence: 99%

Further evidence for allergic pathophysiology in allergic fungal sinusitis

1998

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“…Virtually all paranasal sinus fungus balls are caused by Aspergillus spp, with A. fumigatus being the most common organism, followed by A. flavus. 13 Paranasal sinus fungus balls differ significantly from allergic fungal sinusitis: they occur in an older age group, show female predominace, and lack associated features such as peripheral eosinophilia or strong association with asthma. 10,11 Most likely these were actually due to Aspergillus spp in which the septation of the hyphae was not appreciated.…”

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confidence: 99%

Paranasal sinus fungus balls

1997

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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 sinusitis and invasive fungal disease were excluded. Results The fungus balls 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 occur 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. © 1997 John Wiley & Sons, Inc. Head Neck 19:481–486, 1997.

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“…Rarely, paranasal sinus fungus ball is due a dematiacious fungus (Fonsecaea pedrosoi), Paecilomyces, Cladosporium, and Penicillium. 13 Paranasal sinus fungus balls differ significantly from allergic fungal sinusitis: they occur in an older age group, show female predominace, and lack associated features such as peripheral eosinophilia or strong association with asthma. Although fungus balls typically involve a single sinus, multiple sinuses can be involved, as is typical of allergic fungal sinusitis.…”

mentioning

confidence: 99%

Paranasal sinus fungus balls

1997

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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 sinusitis and invasive fungal disease were excluded.Results. The fungus balls 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 occur 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.

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Phaeohyphomycosis of the paranasal sinuses masquerading as a neoplasm: A case report

Cited by 7 publications

References 12 publications

Further evidence for allergic pathophysiology in allergic fungal sinusitis

Further evidence for allergic pathophysiology in allergic fungal sinusitis

Paranasal sinus fungus balls

Paranasal sinus fungus balls

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