We present a case of maxillary sinusitis caused by Schizophyllum commune, in a 50-year-old female. The patient presented with nasal obstruction, purulent nasal discharge from right side of the nose, cough, headache, and sneezing. Computed tomography revealed extensive opacity of the right maxillary sinus as well as erosion of the nasal wall and maxillary bone. Functional endoscopic sinus surgery was done, and fungal debris present on right side of the maxillary sinus was removed and sent to laboratory. Potassium hydroxide (KOH) examination of the nasal discharge showed hyaline, septate hyphae. Primary isolation on Sabouraud's dextrose agar (SDA) yielded a white woolly mould. Banana peel culture after 8 weeks showed macroscopically visible fan-shaped fruiting bodies. Lactophenol cotton blue (LPCB) mount of the same revealed hyaline septate hyphae, often with clamp connections. Identification was confirmed by the presence of clamp connections formed on the hyphae and by vegetative compatibility with known isolates.
A 70 year old female patient presented with complaints of pain, watering and swelling in the right eye. She gave a history of fall, as she was walking in the paddy field of her farm. Ophthalmological and Microbiological investigation revealed a fungal keratitis with an unusual fungus Macrophomina phaseolina which is primarily a plant pathogen, with a potential to cause human infections especially in immuno-compromised patients. The patient responded well to the antifungal treatment with Oral Voriconazole with absence of recurrence and dissemination.
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. We hereby report three cases of fungal sinusitis caused by uncommon Aspergillus such as A. versicolor and A. sydowii. Case 1 was a 40-year-old female came with complaints of nasal block and nasal discharge for past one and a half years with history of previous nasal surgery. Her computed tomography (CT) scan of paranasal sinus (PNS) showed bilateral ethmoidal sinusitis. Case 2 was a 43-year-old male known asthmatic presented with complaints of nasal block for last five years, was diagnosed to have bilateral sinonasal polyposis by anterior rhinoscopy. Case 3 was a 17-year-old female known asthmatic presented with headache, nasal discharge and frequent sneezing for last six months. Her CT PNS showed left side deviated nasal septum with left side pan sinusitis along with right frontal sinusitis. All the three patients underwent functional endoscopic sinus surgery (FESS). The material was sent to the microbiology laboratory for fungal culture and potassium hydroxide mount. Speciation by slide culture was not conclusive. Hence, molecular methods were opted for speciation. Conclusion: Reporting of these cases will ensure awareness among the microbiologists about the not so common Aspergilli as a cause of fungal sinusitis. The need of molecular methods for speciation has also been emphasized here as it is difficult to speciate these Aspergilli using routine conventional methods.
IJCRI publishes
We report two cases of complicated Urinary Tract Infection, one with nephrostomy tube left
in-situ
and other with bladder outlet obstruction, caused by
Trichosporon loubieri
. Both patients responded well to antifungal treatment along with change/removal of catheters. In both the cases, correct identification of
T. loubieri
was done by IGS1 sequencing. Prompt identification and timely management headed to good clinical outcome. Hence, clinicians should be aware of
T. loubieri
as an emerging fungi causing human infections.
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