DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20212909

Diagnostic dilemma in a case of chronic invasive fungal sinusitis solved using a novel diagnostic test

Malavika Suresh, Maneesh Shivaputra Ganamukhi, Maneesh Shivaputra Ganamukhi, Sobhana Chandran, Sobhana Chandran, Saranya Sasikumar, Saranya Sasikumar

Abstract


Fungal infections of the paranasal sinuses are a spectrum of diseases rather than one distinct entity. The prevalence of fungal sinus disease has been increasing in recent decades, especially in immunocompetent individuals. The indiscriminate use of antibiotics and immunosuppressive drugs has partially been attributed to this. The diagnosis of invasive fungal disease still imposes a challenge to medical professionals occasionally. Here we present an interesting case of a middle-aged immunocompetent male who presented to us with non-specific symptoms of chronic invasive fungal sinusitis. The routine investigations for diagnosing fungal sinusitis turned out to be futile and the result of serum galactomannan test helped to identify and treat his condition. 

 


Keywords


Fungal sinusitis, Immuno competent, Chronic invasive Aspergillosis, Orbital apex, Serum galactomannan

Full Text:

PDF

References


deShazo RD, O'Brien M, Chapin K, Soto-Aguilar M, Gardner L, Swain R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1997;123(11):1181-8.

Pekala KR, Clavenna MJ, Shockley R, Weiss VL, Turner JH. Chronic invasive fungal sinusitis associated with intranasal drug use. Laryngoscope. 2015;125(12):2656-9.

Deutsch PG, Whittaker J, Prasad S. Invasive and Non-Invasive Fungal Rhinosinusitis-A Review and Update of the Evidence. Medicina (Kaunas). 2019;55(7):319.

Deshazo RD. Syndromes of invasive fungal sinusitis. Med Mycol. 2009;47(1):309-14.

Patterson TF, Thompson GR, Denning DW, Fishman JA, Hadley S, Herbrecht R, et al. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;63(4):1-60.

Singh V. Fungal Rhinosinusitis: Unravelling the Disease Spectrum. J Maxillofac Oral Surg. 2019;18(2):164-79.

Nucci M, Carlesse F, Cappellano P, Varon AG, Seber A, Garnica M, Nouér SA, Colombo AL. Earlier diagnosis of invasive fusariosis with Aspergillus serum galactomannan testing. PLoS One. 2014;9(1):e87784.

de Heer K, Gerritsen MG, Visser CE, Leeflang MM. Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients. Cochrane Database Syst Rev. 2019;5(5):CD012399.

Neofytos D, Railkar R, Mullane KM, Fredricks DN, Granwehr B, Marr KA, et al. Correlation between Circulating Fungal Biomarkers and Clinical Outcome in Invasive Aspergillosis. PLoS One. 2015;10(6):e0129022.

Singh S, Kaur H, Choudhary H, Sethi S, Malhotra P, Gupta KL, Rudramurthy SM, Chakrabarti A. Evaluation of biomarkers: Galactomannan and 1,3-beta-D-glucan assay for the diagnosis of invasive fungal infections in immunocompromised patients from a tertiary care centre. Indian J Med Microbiol. 2018;36(4):557-63.

Pfeiffer CD, Fine JP, Safdar N. Diagnosis of invasive aspergillosis using a galactomannan assay: a meta-analysis. Clin Infect Dis. 2006;42(10):1417-27.

Maertens J, Verhaegen J, Lagrou K, Van Eldere J, Boogaerts M. Screening for circulating galactomannan as a noninvasive diagnostic tool for invasive aspergillosis in prolonged neutropenic patients and stem cell transplantation recipients: a prospective validation. Blood. 2001;97(6):1604-10.

Gupta V, Gupta A. Prevalence and clinical profile of patients with chronic fungal maxillary sinusitis. Int J Otorhinolaryngol Head Neck Surg. 2019;5:280-4.




Bookmark and Share