Abstract
We present a rare case of eosinophilic fungal rhinosinusitis with nasal polyps in a 32-year-old woman caused by basidiomycete fungus Schizophyllum commune. Diagnosis was done by the endoscopic nasal examination, computed tomography (CT) of the paranasal sinuses, the histopathological examination of polyps, the presence of eosinophils and fungal hyphae in nasal mucus and by the detection of S. commune by culture. The patient was successfully treated by combination of oral itraconazole and topical corticosteroid therapy combined with surgery. The pathogenesis and diagnosis of allergic fungal rhinosinusitis are also discussed.
Highlights
Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and paranasal sinuses that is present for at least 12 weeks without complete resolution [11]
Nasal polyposis (NP), which is considered to be a subgroup of CRS, is defined as a chronic inflammatory disease of nasal and paranasal sinuses mucosa leading to diffuse formation of benign polyps protruding from sinuses into the nasal cavity [11]
Non-invasive sinusitis can be divided into two forms: allergic fungal rhinosinusitis (AFRS), and sinus mycetoma, which occurs in immunocompetent patients [14, 19]
Summary
Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and paranasal sinuses that is present for at least 12 weeks without complete resolution [11]. Invasive fungal sinusitis commonly occurs in patients with diabetes, or in individuals who are immunocompromised and is characterized by its invasiveness, tissue destruction and rapid onset. It spreads rapidly, via vascular invasion, into the orbit and central nervous system [14, 19]. Non-invasive sinusitis can be divided into two forms: allergic fungal rhinosinusitis (AFRS), and sinus mycetoma (fungal ball), which occurs in immunocompetent patients [14, 19]. A 32-year-old woman presented with a one-year history of bilateral nasal obstruction, anosmia, bilateral purulent nasal discharge and facial pain She had no history of systemic predispositions such as diabetes mellitus, neutropenia, immunodeficiency or previous corticosteroid therapy.
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