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Chronic granulomatous invasive fungal sinusitis: an evolving approach to management
Author(s) -
Halderman Ashleigh,
Shrestha Rabin,
Sindwani Raj
Publication year - 2014
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21299
Subject(s) - medicine , voriconazole , conservative management , chronic granulomatous disease , sinusitis , chronic sinusitis , surgery , dermatology , antifungal , immunology
Background Chronic granulomatous invasive fungal sinusitis (CGIFS) is rare and a consensus on ideal management is lacking. We present an extensive case managed successfully with a conservative approach. Methods Case report and literature review. Results The patient presented with unilateral proptosis, papilledema, and headache. Imaging revealed an infiltrative process with extensive intracranial and intraorbital involvement. Biopsy showed fungal elements and granulomatous reaction consistent with CGIFS. The patient was managed with conservative surgery and long‐term oral voriconazole. Conclusion This case supports a conservative surgical approach in some patients with extensive CGIFS. Oral voriconazole is effective and has significant advantages over more toxic agents administered intravenously.