10.5937/mckg48-4337 = Non-invasive chronic fungal inflammation of the maxillary sinus mucosa as a cause of long-term cough: Case report

Abstract

A fungal ball consists of a dense conglomerate of fungal hyphae growing at the surface of the sinus mucosa without tissue infiltration. Maxillary sinus is the most commonly involved paranasal sinus cavity. In this paper, we described a case of a woman with fungus ball in the right maxillary sinus. The long-term cough was the most dominant symptom. A 64-year-old patient was referred to our department with a one-year history of refractory nocturnal cough, right-sided nasal obstruction, facial pain and sense of pressure. Computed tomography (CT) of the paranasal sinuses showed heterogeneous opacification of the right maxillary sinus with focal area of bone or tooth density. After endoscopic sinus surgery, the removed content is sent for microbiological and pathohistological examination. The results showed the presence of non-invasive fungal infection, caused by microorganisms Aspergillus flavus. Two months after the surgical treatment, the patient was free of symptoms and with normal clinical findings in the nose and paranasal sinuses. Fungus ball should be suspected in any case of difficult to treat or recurrent unilateral sinusitis, especially in cases of association with long-term cough.