Aspergilloma Research Articles

Long-term follow-up of an Aspergillus fungus ball

Long-term follow-up of an Aspergillus fungus ball

Aspergilloma: Clinical Manifestation After Tuberculosis Infection

Aspergilloma is a mass-like fungus ball consisting of Aspergillus fumigatus. Aspergilloma occurs in patients with pulmonary structural abnormalities in which the presence of a previous cavity is the predisposing factor that most often results in Aspergillus colonization, especially in tuberculosis endemic countries. 28 y.o and 33 y.o female , complained of hemoptysis, chest pain, weight loss, and a history of TB treatment. The chest X-ray and CT scan revealed a solid lesion with an “Air-crescent sign” indicating Aspergilloma lesion. Patients were given symptomatic, anti-fungal drugs, and supported by embolization procedure to reduce hemoptysis. The patient's condition began to improve after treatment. Imaging findings in x-rays and CT scans that point to Aspergilloma will help doctors in further management to provide a better prognosis for the patient.

High CT Attenuation Values Relative to the Brainstem Predict Fungal Hyphae Within the Sinus.

ObjectivesThere is currently no established objective diagnostic indicator for the differentiation of sinus fungal ball (SFB) from unilateral nonfungal chronic sinusitis (UCRS). This study evaluated whether computed tomography (CT) attenuation values relative to those of the brainstem (relative CT number) are useful for differentiating SFB from UCRS.Materials and MethodsConsecutive patients who were pathologically diagnosed with SFB or UCRS between 2013 and 2021 were retrospectively identified. The relative CT numbers of region of interest (ROIs) within the sinuses were compared between the two patient groups. Factors with predictive power for differentiating SFBs from UCRSs were identified by uni/multivariable logistic regression analyses.ResultsOne hundred and eighty-three patients with unilateral chronic sinusitis were finally analyzed (SFB, 86 cases; UCRS, 97 cases). Regardless of the presence or absence of calcified lesions, the relative CT numbers in SFB were significantly higher than those in UCRS. ROIs showing high relative CT numbers were those where fungal hyphae were present. In the uni/multivariable logistic regression analysis, age (p < 0.001), relative CT number (p < 0.001), and calcification (p = 0.002) had predictive value for distinguishing SFB from UCRS. Within those cases not showing calcification, age (p = 0.004) and relative CT number (p < 0.001) were predictive factors for differentiating SFB from UCRS. A relative CT number >1.5 was significantly associated with SFB (sensitivity, 70%; specificity, 91%), with a significantly larger area under the receiver operating characteristics curve than age.ConclusionsHigh relative CT numbers within the sinus are strongly associated with the presence of fungal hyphae, and measurement of relative CT number is a powerful adjunctive diagnostic method for distinguishing between SFB and UCRS.

Videourology Abstracts

Journal of EndourologyVol. 36, No. 6 AbstractsFree AccessVideourology AbstractsPublished Online:7 Jun 2022https://doi.org/10.1089/end.2022.29124.vidAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail A Unique Urine Isolating Drape Technique for On-Table Pyeloscopy to Exclude Suspected Upper Tract Urothelial Carcinoma During Radical CystectomyZein Alhamdani, MD,1 Sean Ong, MBBS,2 Nathan Lawrentschuk, MBBS PhD FRACS (Urology),3 and Dixon Woon, MBBS (Hons), DMedSc, FRACS (Urology)11Department of Surgery, University of Melbourne, Austin Health, Heidelberg, Australia.2Department of Surgery, University of Melbourne, Parkville, Australia.3Department of Urology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.Clinical History: A 72-year-old man undergoes a transurethral resection of a 1.5 cm bladder tumor completely obliterating the left ureteral orifice (UO). A radical cystectomy was performed as the tumor was found to be a high-grade pT2 urothelial carcinoma. A computed-tomography intravenous pyelogram phase clearly demonstrated a filling defect in the left lower pole and renal calix; however, an magnetic resonance imaging postcontrast failed to detect the same filling defects, possibly secondary to inadequate filling as the obstruction progressed.Physical Examination: Physical examination was unremarkable and vital signs were within normal parameters.Diagnosis: The history raises high clinical suspicion for an upper tract urothelial carcinoma. At a multidisciplinary team meeting, some surgeons advocated for a radical nephroureterectomy, others a unique drape technique that facilitates on-table pyeloscopy.Intervention: To investigate the upper tract filling defect, retrograde pyeloscopy was not possible because of the obliterated left UO. Our novel technique is the first described to facilitate on-table pyeloscopy with an open ureter that diverts ureteral fluid into a pouch instead of the abdomen after radical cystectomy when upper tract access is not otherwise possible. The diversion of ureteral fluid from the abdominal cavity minimizes the catastrophic theoretical risk of tumor seeding1–5 that has been known to happen along percutaneous nephrostomy tracts.6Follow-up/Outcomes: The filling defect was most likely caused by a fungal ball seen on pyeloscopy, and as there were no signs of malignancy observed this patient was saved from a potential nephroureterectomy.Patient consent statement: “I give full informed consent to the research team for this research project including recording of the operation for the purposes of research and publication of a video and any written materials.”http://online.liebertpub.com/doi/full/10.1089/vid.2022.0018

DRAMATIC IMPROVEMENT OF ADULT PATIENTS WITH POST-TB PULMONARY PNEUMATOCELE AND BAD PULMONARY FUNCTION AFTER SURGICAL INTERVENTION

TYPE: Late Breaking Case Report TOPIC: Cardiothoracic Surgery INTRODUCTION: Pulmonary pneumatoceles (PCs) are thin walled air-filled cysts that develop within pulmonary parenchyma. PCs are developed after infection,or trauma. PCs caused as a complication of Staphylococcus pneumonia, and are more frequently in infants and children. Adult tuberculous pulmonary pneumatoceles are seldom [1]. PCs are asymptomatic. Large PCs may compress adjacent lung with mediastinal shift causing cardiopulmonary symptoms [2]. Surgical intervention is indicated when PCs cause cardiopulmonary compromise or rupture into the pleural space or unresolved infection [3]. CASE PRESENTATION: 60-years female patient presented by dry cough and shortness of breath (SOB). She was on corticosteroid therapy as treatment of bronchial asthma. She had history of resolved pulmonary TB. Clinical examination revealed diminished air entry . CXR showed translucent zone. CT with contrast showed large PC occupying >2/3 of hemithorax with mediastinal shift. During operation, rupture of PC by diathermy to avoid its over-inflation during ventilation , and wedge resection with fistula site repair through uniportal VATS.Closure of thoracotomy was performed as a routine with two ICT. Postoperative CXR revealed full inflated lung . They discharged with smooth postoperative course. DISCUSSION: PC in adult can occur during or after anti-TB treatment [3]. there was a history of resolved TB. Urgent surgery indicated in complicated PC (infection, tension, rupture). [6]. VATS procedure performed to PC excision and repair. CONCLUSIONS: Surgical excision of symptomatic complicated pulmonary pneumatocele with mini approach after well preparation gives marvelous improvement of respiratory condition. DISCLOSURE: Nothing to declare. KEYWORD: Pulmonary Pneumatocele, Pulmonary Tuberculosis, Fungal Ball, Cardiopulmonary Compromise.

Malignant course of invasive pulmonary aspergillosis in the new coronavirus infection COVID-19

Respiratory infections caused by fungal pathogens are the main cause of death in immunocompromised patients. During the COVID-19 pandemic, the registration of respiratory fungal pathology, especially pulmonary aspergillosis, has increased significantly.&#x0D; We present a histopathologically confirmed case of fatal invasive pulmonary aspergillosis complicating COVID-19. A 65-year-old patient with long-term diabetes backgrounded with a severe course of COVID-19 (the virus was identified ICD-10 code U07.1) described. During the illness bilateral polysegmental pneumonia of fungal-bacterial (Klebsiella pneumoniae) etiology with necrosis and sequestration of the affected tissue the lower lobe of the right lung with the formation of a fungal ball and the development of a right-sided pneumothorax was developed. In other parts of both lungs, focal destruction of the interalveolar septa was determined with the formation of small cavities filled with detritus and accumulations of segmented neutrophils, with the proliferation of fungal mycelium, positively stained in the PAS reaction. Fungal hyphae and conidial heads were also found in the lumens of individual bronchi and vessels with invasion of their walls. Long-term (more than one month) course of the disease, clinical and radiological dynamics, and detection of a forming connective tissue capsule along the periphery of the necrosis zone during microscopy testifies in favor of the subacute nature of the infection.&#x0D; The presented clinical case, as well as a review of current publications and meta-analyses on invasive pulmonary aspergillosis, point to diagnostic problems and poor outcomes of invasive pulmonary aspergillosis in patients with COVID-19.&#x0D; Pulmonary aspergillosis associated with COVID-19 is a serious and potentially life ― threatening complication in patients with severe COVID-19 receiving immunosuppressive treatment. Early diagnosis of fungal infections is crucial to ensure the survival of such patients. Targeted biopsy examination with microscopy and/or seeding of a lung biopsy allows not only to establish the diagnosis of aspergillosis, but also to determine the presence of tissue invasion.&#x0D; Further research should include approaches aimed at developing an effective diagnosis of fungal tissue invasion and respiratory tract damage, determining the patients immune status in order to conduct personalized immunotherapy.

A Case of Iris Neovascularization in Severe Fungal Keratitis Treated with Intracameral Bevacizumab

Purpose: We report a case in which iris neovascularization (NVI) improved after intracameral bevacizumab injection in a patient who exhibited fungal keratitis with NVI.Case summary: A 47-year-old man experienced a tree branch-induced injury to his right eye and was treated for keratitis for 1 month. However, his condition deteriorated and he was referred to our hospital. Initial slit lamp biomicroscopy findings showed a large, thick central deep stromal infiltration with a concentric circle shaped feathery-like margin, epithelial defect, satellite lesion, fungal ball, hypopyon, and NVI. Aspergíllus fumigatus was isolated in the corneal scraping culture. Amphotericin B, voriconazole, and natamycin were administered as topical treatment along with systemic amphotericin B. After treatment, the corneal lesions gradually improved, but NVI worsened. After the 5th week, total hyphema occurred; anterior chamber irrigation and intracameral bevacizumab injection were performed. Two weeks postoperatively, the NVI exhibited complete regression; corneal stromal melting with descemetocele appeared after 8 weeks. Penetrating keratoplasty was performed and NVI was no longer observed at 6 months after surgery.Conclusions: For the treatment of iris neovascularization in patients with infectious keratitis, intracameral bevacizumab injection at an appropriate time may be effective.

Prevalence of chronic pulmonary aspergillosis regarding time of tuberculosis diagnosis in Brazil.

Data on the prevalence of chronic pulmonary aspergillosis (CPA) in patients with active or cured tuberculosis (TB) are scarce, mainly due to diagnostic difficulties. The diagnosis of CPA is based on pulmonary symptoms and chest computed tomography (CT) scans and is considered confirmed when there is microbiological or serological evidence of Aspergillus spp. To estimate the prevalence of CPA in patients treated or undergoing treatment for PTB, seen in two referral hospitals in Mato Grosso do Sul, Brazil. A total of 193 consecutive patients who were treated or previously treated for pulmonary tuberculosis underwent prospective evaluation: (a) clinical evaluation; (b) chest CT scan; (c) sputum examination-culture for fungi and smears for direct mycology; (d) detection of anti-Aspergillus fumigatus antibodies using an enzyme-linked immunosorbent assay Platelia® test; and (e) anti-Aspergillus spp. antibodies were assessed via a DID test. The global prevalence of CPA was 10.9% (95% confidence interval, 7.2%-16.1%), but it increased with the time of TB diagnosis. The variables independently associated with CPA were previous pulmonary tuberculosis over 4 years ago and haemoptysis. Cavities, pleural thickening and the presence of a fungal ball were the most frequent tomographic findings in patients with CPA. The high prevalence observed and its increase over time suggest the need for continuous surveillance of CPA in patients with active or previous pulmonary tuberculosis and throughout life, with clinical, tomographic and serological evaluations (ELISA) for a timely diagnosis and a better prognosis.

Assessment of airborne fungi from animal establishments in and around Kolkata, West Bengal

Background: Airborne transmission of pathogenic Fungi to humans from the environment, animals, or other humans are very common and cause various disease like Aspergillosis, aspergilloma (fungus ball), allergic sinusitis, and allergic bronchopulmonary disease, Flu-like illness, chronic lung disease etc. Materials and methods: The present study was conducted to analyze fungi present in around the environment of local meat market, fish market and farms. This was determined through air quality sampling using the ‘Settle plate technique’ using SDA agar plate and were analyzed at 37°C and 25°C after incubation using Lactophenol cotton blue mount. Results: The highest number of fungi were isolated from farms (37%) followed by chicken shop (24%) , Mutton shop(23%) and fish shops(16%). Aspergillus flavus(21%) was prominent in chicken shop while AspergIllus fumigatus(19%) was prominent in Mutton shop. Fusarium (19%) and Rhizopus spp.(18%) were prominent in farm air. Conclusion: The study is significant from One health point of view and stresses the importance of proper ventilation , sanitation and importance of sunlight in order to minimize load of fungi in air.

Sphenoid Sinus Fungal Ball Presenting as Ipsilateral Primary Aberrant Regeneration of the Third Cranial Nerve.

Lin, Michael BMed, BSc(Med)Hons, MD; Huang, Jessica J. M. BMed; Jiang, Ivy W. BMed; Spencer, Sascha K. R. BMed, MD; Campbell, Raewyn G. FRACS, BMed(Hons), BAppSc(Physio), GradDipEx&SportSc, FARS; Panizza, Ben MBA, FRACS, FACS; Sach, Toos A. FRANZCR; Francis, Ian C. FRANZCO, FRACS, PhDEditor(s): Avery, Robert DO; Golnik, Karl C. MD; Froment, Caroline MD, PhD; Wang, An-Guor MD Author Information

Chronic pulmonary aspergillosis in patients with active pulmonary tuberculosis with persisting symptoms in Uganda.

The occurrence of chronic pulmonary aspergillosis (CPA) among drug sensitive pulmonary tuberculosis (PTB) patients on optimal therapy with persistent symptoms was investigated. We consecutively enrolled participants with PTB with persistent pulmonary symptoms after 2months of anti-TB treatment at Mulago Hospital, Kampala, Uganda, between July 2020 and June 2021. CPA was defined as a positive Aspergillus-specific IgG/IgM immunochromatographic test (ICT), a cavity with or without a fungal ball on chest X-ray (CXR), and compatible symptoms >3months. We enrolled 162 participants (median age 30years; IQR: 25-40), 97 (59.9%) were male, 48 (29.6%) were HIV-infected and 15 (9.3%) had prior PTB. Thirty-eight (23.4%) sputum samples grew A.niger and 13 (8.0%) A.fumigatus species complexes. Six (3.7%) participants had intracavitary fungal balls and 52 (32.1%) had cavities. Overall, 32 (19.8%) participants had CPA. CPA was associated with prior PTB (adjusted odds ratio [aOR]: 6.61, 95% CI: 1.85-23.9, p=.004), and far advanced CXR changes (aOR: 4.26, 95% CI: 1.72-10.52, p=.002). The Aspergillus IgG/IgM ICT was positive in 10 (31.3%) participants with CPA. Chronic pulmonary aspergillosis may cause persistent respiratory symptoms in up to one-fifth of patients after intensive treatment for PTB. The Aspergillus IgG/IgM ICT positivity rate was very low and may not be used alone for the diagnosis of CPA in Uganda.

Case Report: 43-years old-Male with Pulmonary Sequestration which Mimics Lung Tumor and Aspergillosis

Background: Pulmonary sequestration is a very rare congenital abnormality of the lung, which was responsible for 0.15-6.4% of all cases of congenital lung formation disorders. Pulmonary sequestration is often seen as recurrent pneumonia, accompanied by complaints of chest pain, shortness of breath and hemoptysis. Conventional angiography is the gold standard for diagnosing pulmonary sequestration and for demonstrating arterial supply and venous drainage. The optimal therapy for pulmonary sequestration is operative resection to avoid infection and damage to the lung parenchyma. Case Report: We reported a case of 43-years old-male with pulmonary sequestration, previously diagnosed with a lung tumor with massive left pleural effusion and pneumonia. A series of diagnostic tests found no malignant cells. During FNAB with CT scan guiding, we found an image of a fungus ball, thus, he was diagnosed with Aspergillosis. The patient was planned to undergo VATS. There were complications during the operation, thus, a lobectomy with an open thoracotomy was performed, and an arterial anomaly was found from the abdominal aorta. The operation was successful and the patient was able to carry on with his normal activities.Conclusion: Establishing a definite diagnosis of pulmonary sequestration is very difficult, and in this case, it was done through lobectomy with thoracotomy and through a multidisciplinary approach.

Management of Fungal Rhinosinusitis: Experience From a Tertiary Care Centre in North India.

IntroductionFungal rhinosinusitis (FRS) has increased over the past few decades due to the rampant use of antibiotics, steroids, immunosuppressive drugs, increased incidence of HIV and uncontrolled diabetes. The current study reviews the types, clinical presentation, microbiology, histopathology and outcomes related to FRS in a tertiary care center in North India.MethodsWe retrospectively reviewed the clinical and follow-up records of patients diagnosed with FRS over three years. The data reviewed included clinical workup, ophthalmological profile, comorbidities, immunological status, radiological investigations, intraoperative and histopathological findings, treatment and follow-up records. In addition, we performed a descriptive analysis of the reviewed data.ResultsThe study consisted of 30 FRS patients (16 male, 14 female). In that, 77% of cases were of allergic FRS, while fungal ball, chronic invasive, chronic granulomatous and acute invasive FRS represented 3%, 10%, 3% and 7% cases, respectively. The most common presentation in non-invasive forms was nasal obstruction, nasal discharge, hyposmia and polyposis, while it was facial pain and headache in the invasive varieties. After appropriate medical and surgical management through endoscopic sinus surgery, the recurrence rate in non-invasive and invasive fungal sinusitis was 16.6% and 20.8%, respectively. There was nil mortality at a minimum of one year of follow-up.ConclusionThe non-invasive forms of FRS are common and have a relatively mild course. Early medical and surgical intervention and management of the underlying comorbidities are the key factors in managing invasive FRS. Close follow-up after surgery is also necessary for the timely detection and management of recurrences.

PREVALENCE OF FUNGAL ISOLATES IN UNILATERAL SINONASAL DISEASE

Fungal sinusitis has been on a rising trend and poses a health burden. Our study aims to nd out the prevalence of fungal isolates in unilateral sinonasal disease and its association with diabetes mellitus. A prospective study was conducted for 2years from August 2017 to August 2019. 150 patients were selected for study based on history, Diagnostic nasal endoscopy and radiological ndings. Patients were subjected to Functional Endoscopic Sinus Surgery (FESS). Sample collected has been sent for fungal smear, fungal culture and Histopathological examination. 50 (33.3%) patients were diagnosed with fungal rhinosinusitis based on fungal smear positivity and histopathology showing fungal elements. 100 (66.7 %) patients were categorized as non-fungal rhinosinusitis. Among the cases of fungal rhinosinusitis, 28 patients (56% of fungal rhinosinusitis) were diagnosed as allergic fungal rhinosinusitis, 15 patients (30% of fungal rhinosinusitis) were diagnosed as acute invasive fungal rhinosinusitis and 7 patients (14 % of fungal rhinosinusitis) were categorized as a fungal ball. A strong association has been found between fungal sinusitis and diabetes mellitus.

Rigidoporus corticola Colonization and Invasive Fungal Disease in Immunocompromised Patients, United States.

We report 2 cases of Rigidoporus corticola (Oxyporus corticola) infection in humans in the United States. Clinical manifestations consisted of angioinvasive fungal sinusitis in 1 patient and pulmonary intracavitary fungus ball in the other patient. These cases illustrate previously undescribed clinicopathologic manifestations of infection by this filamentous basidiomycete in humans.

Clinical Characteristics According to the Radiological Classifications of Maxillary Sinus Fungus Ball

Background and Objectives: The purpose of this study was to classify radiological findings of patients diagnosed with maxillary sinus fungus ball and to analyze the differences in surgical approach methods and postoperative results.Methods: As a retrospective study, we reviewed the medical records of 221 patients (unilateral in 216: bilateral in 5).Results: On computed tomography (CT), 49% of the lesions had an irregular surface or a protruding part. There was a significant difference in surgical approach according to pneumatization of the maxillary sinus when middle meatal antrostomy (MMA) was performed alone or combined with MMA and inferior meatal antrostomy (IMA) (p=0.042). Extension of a maxillary sinus lesion caused by fungus ball was not associated with stenosis of the MMA (p=0.328).Conclusion: Diagnosis of maxillary sinus fungus on CT was associated with irregular lesion surface or a protruding calcification. In patients with fungus ball of the maxillary sinus, the more severe is the maxillary sinus pneumatization, the larger is the extent of IMA needed.

Comparative evaluation of methods for detecting fungal bodies of the paranasal sinuses

The aim of the work was to study the diagnostic value of clinical, microbiological and histopathological methods for detecting the fungal balls of the paranasal sinuses. Material and methods. An analysis of investigation and treatment of 17 patients was carried out, in whom structureless caseous masses were found during endoscopic sinus surgery, which were possible to suspect the presence of a fungal ball. The examination of the material removed during the operation included microscopy, culture and histopathological examination. Results. Histopathological examination confirmed the clinical diagnosis of fungal infection in all 17 patients with isolated lesions of the sphenoid sinus. Primary microscopy revealed fungal mycelium in 70.5 % of cases). Mycological study found the growth of filamentous fungi in 29.4 % of histopathologically confirmed cases.

Phaeoacremonium cinereum: an uncommon microorganism causing rare occurence of isolated right sphenoid fungal rhinosinusitis

&lt;p class="abstract"&gt;Fungal rhinosinusitis (FRS) can be either invasive or non-invasive, with the later characterized by the disease confined to the paranasal sinuses, mucous membrane, and bone wall without fungal invasion, including fungus ball (FB) and allergic fungal rhinosinusitis. Infection involving sphenoid sinus usually provokes headache or involvement of the surrounding cranial nerves due to its unique and posterior location in the nasal cavity. We encountered a case of right isolated sphenoid non-invasive fungal sinusitis caused by rare microorganism namely Phaeoacremonium cinereum. The disease was diagnosed based on clinical, endoscopy, radiological findings as well as specimen culture and sensitivity. Computed tomography (CT) scan provides information regarding the extension of sinusitis to dental, orbit, cranial bones and intracranial region. Once the diagnosis of sphenoid fungal rhinosinusitis is made, endoscopic sphenodotomy is the treatment of choice.&lt;/p&gt;

Trans-superior meatal surgery: A targeted approach for isolated posterior ethmoid diseases

BackgroundSurgical treatment for posterior ethmoid diseases has historically been performed through a trans-ethmoid approach which usually required medialization of the middle turbinate, a middle meatal antrostomy and total ethmoidectomy. This can destabilize the basal lamella of the middle turbinate and also sacrifices the integrity of ostiomeatal complex and the healthy bulla if the patient has the disease only in the posterior ethmoid sinus.The aim of this study is to present of a novel minimally disruptive approach for the management of isolated posterior ethmoid diseases. MethodsRetrospective case series analysis. Results19 patients with isolated posterior ethmoid fungal balls were operated on via a trans-superior meatal approach. The most common signs and symptoms were headache (78.9%), and purulent/mucoid discharge from the superior meatus (89.5%). The technique is described in detail with the preservation of the ostiomeatal complex and bulla ethmoidalis. Complete removal of the disease was achieved in all cases through this access, with no intra-operative complications. The posterior ethmoid cavity remained patent postoperatively in all patients. No recurrence was noted during the follow-up period which ranged from 6 to 12 months. ConclusionThis is a minimally invasive approach, which is safe and effective for the surgical management of isolated posterior ethmoid diseases.

The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls.

Background Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims to emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion Fungal ball may present with variety of symptoms but most commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.