<p class="abstract"><strong>Background:</strong> Fungal sinusitis is a distinct clinical entity characterized by inflammation of the sinus mucosa caused by fungal infection like aspergillus (fumigatus, niger, flavus), mucormycosis, candida (albicans), scedosporium, pencillium. Mostly immunocompromised patients, farmers, garbage cleaners, and patients on prolonged nasal sprays are affected. There are different types of fungal sinusitis: fungal mycetoma, allergic fungal, chronic indolent and fulminant sinusitis having symptoms like chronic headache and facial swelling with visual impairment. Patients have thick purulent nasal discharge, nasal obstruction, epistaxis, cheek swelling and may be polyposis. Resident bacterial flora probably inhibits colonization by fungi through a number of mechanisms. Thus antimicrobial therapy predisposes to both the overgrowth of normal fungal flora, e.g., Candida species, and growth of opportunists like Aspergillus<sup>1</sup>. Allergic fungal rhinosinusitis is the most common entity. Aspergillosis is the most common fungal infection. Of these aspergillus fumigatus is the most common fungal pathogen. Maxillary sinuses are commonly involved.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study carried out at department of otorhinolaryngology at Kunal Institute of Medical Specialities Pvt Ltd. Evaluation by proper history taking and clinical examination after which the patient is selected for nasal swab, culture and sensitivity. Plain x-ray nose and paranasal sinuses. CT scans nose and paranasal sinuses. Diagnostic nasal endoscopy. </p><p class="abstract"><strong>Results:</strong> Allergic fungal sinusitis was the most common entity found with aspergillosis being the most common organism.</p><p><strong>Conclusions:</strong> Allergic fungal sinusitis was most commonly found in the age group of 20 to 29 years with maxillary sinus most commonly affected. </p>
<p>Rosai-Dorfman’s disease also known as sinus histiocytosis with massive lymphadenopathy (SHML) is characterized by distorted lymph node architecture with marked dilation of lymphatic sinuses occupied by numerous lymphocytes, as well as histiocytes with vesicular nucleus and abundant clear cytoplasm with phagocytized lymphocytes or plasma cells, also known as ‘emperipolesis’. This disease of unknown etiology progresses with a benign prognosis strictly and only when an early diagnosis and treatment is made. A late diagnosis and a generalized lymph node involvement contribute to a poor prognosis. We reported a case of a 29-year-old Indian female with a 4-month history of painful unilateral cervical mass and low-grade fever with the final diagnosis of Rosai-Dorfman disease. The final diagnosis was made by fine needle aspiration (FNA) biopsy of the cervical lymph node. In conclusion, FNA biopsy can be enough to make the diagnosis in most cases due to the distinct cytological features of SHML, thereby avoiding more invasive approaches that potentially are unnecessary.</p>
<p class="abstract">Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a benign and self-limited disease that mainly affects young women. Patients present with localized lymphadenopathy, fever, and leukopenia in up to half of the cases. KFD can occur in association with systemic lupus erythematosus. We present the case of a patient with KFD and systemic lupus erythematosus. A 38 years old female presented with right sided cervical lymphadenopathy, fever and a rash on the face, with a loss of apetite and generalized body weakness. After a series of investigations to rule out other conditions like tuberculosis, a diagnosis of kikuchi disease was made based on the biopsy report. There was a strong suspiscion of SLE as well pertaining to the facial rash. An ANA profile was done which strongly indicated SLE as well. The patient was started on steroids and other systematic treatment and recovered gradually. With its shared clinical features, Kikuchi-Fujimoto disease can be mistaken for other forms of lymphadenitis. A combined use of medical imaging and laboratory tests is the effective way to avoid misdiagnosis.</p>
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