Invasive fungal granuloma: a diagnostic challenge


  • Abhinav Thaduri Department of Head and Neck Surgery and Oncology, All India Institute of Medical Sciences, Rishikesh, ‎Uttarakhand, India
  • G. Sreekanth Department of ENT, Government Medical College, Mahaboobnagar, Telangana, India
  • Dipin Kumar Vishnuvardan Department of ENT, Gandhi Medical College, Secunderbad, Telangana, India
  • K. Sravani Reddy Department of ENT, Kamineni Institute of Medical Sciences, Hyderabad, Telangana, India



Fungal granuloma, Invasive fungal sinusitis, Sphenoid granuloma


Invasive fungal rhinosinusitis is a rare and life-threatening with high mortality and morbidity. Granulomatous invasive fungal rhinosinusitis has a time course exceeding 12 weeks. This disease has been reported primarily in south of Asia, however, it is very rare. When the invasive fungal sinus infection presents in a form of a granuloma with unusual presentation then they pose a diagnostic challenge to medical professionals. We present a case series of 3 cases of invasive fungal granuloma with varied presentations, which posed as a challenge in diagnosing them. Chronic invasive fungal granuloma (CIFG) of the paranasal sinuses is seen in immunocompetent hosts, especially those that are in the 3rd and 4th decades of their lives. Involvement of maxillary sinus and orbit is common than the sphenoid sinus involvement. Routine H and E staining may prove inadequate. Special stains such as the GMS stain should be employed in the slightest doubt of a fungal aetiology. A team approach towards patients is paramount for early diagnosis and timely medical and surgical intervention.

Author Biography

Abhinav Thaduri, Department of Head and Neck Surgery and Oncology, All India Institute of Medical Sciences, Rishikesh, ‎Uttarakhand, India

Dr.Abhinav Thaduri 

senior resident,

All India Institute of Medical Sciences



Shazo RD, Chapin K, Swain RE. Fungal sinusitis. New England J Med. 1997;337(4):254-9.

Chakrabarti, Sharma SC, Chander J. Epidemiology and pathogenesis of paranasal sinus mycoses. Otolazyngol Head Neck Surg. 1992;107:745-50.

Chakrabarti A, Denning DW, Ferguson BJ, Ponikau J, Buzina W, Kita H, et al. Fungal rhinosinusitis: a categorization and definitional schema addressing current controversies. Laryngoscope. 2009;119(9):1809-18.

Chang C, Gershwin ME, Thompson GR. Fungal disease of the nose and sinuses: an updated overview. Current Allergy Asthma Reports. 2013;13(2):152-61.

Bashburn RG, Kennedy DW, Begley MG, Henderson DK, Bennett JE. Chronic fungal sinusitis in apparently normal hosts. Medicine. 1988;67:231-47.






Case Series