Open AccessNon-invasive fungal sinusitis resulting in multiple cranial nerve neuropathies
Author(s) -
Thomas Hendriks,
Samuel Leedman,
Mark Quick,
Aanand Acharya
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-229094
Subject(s) - medicine , surgery , sinusitis , sinus (botany) , sequestrum , skull , paranasal sinuses , mucormycosis , dehiscence , rare disease , anosmia , osteomyelitis , disease , pathology , botany , covid-19 , infectious disease (medical specialty) , biology , genus
A 33-year-old man presented to the emergency department with a right-sided facial paralysis and maxillary division (V2, trigeminal nerve) paraesthesia. He had been suffering with upper respiratory tract symptoms in the preceding 2 months, including rhinorrhoea, fever and headache. The patient was otherwise fit and immunocompetent. Urgent radiological investigation revealed extensive fungal sinusitis with sphenoid sinus dehiscence and skull base osteitis. The patient underwent emergency endoscopic sinus surgery revealing concretions and debris in the ethmoid and sphenoid sinuses. He was commenced on systemic antifungal therapy and made a full recovery with resolution of his cranial neuropathies. The fungus Schizophyllum commune was isolated and is a rare cause of fungal sinusitis, but with the potential for invasive disease in immunosuppressed individuals.