Bilateral proptosis with hypertelorism - An unusual presentation of extensive allergic fungal sinusitis

Abstract

Allergic fungal rhinosinusitis (AFRS) is one of the most common form of fungal sinusitis. It is a hypersensitivity reaction to fungal infection. The patients are either atopic or immunocompetent. Such patients suffer from rhinosinusitis. The allergic mass is expanding in nature and this results in bony remodelling. It also involves the adjacent structures. Ophthalmological complications occur when the mass involves orbit. These complications include diplopia, telecanthus, proptosis, malar flattening, epiphora, asthenopia and even visual loss. The diagnosis can be made using radiological imaging. Histopathological examination is needed to confirm the diagnosis. The treatment of AFRS includes both surgical and medical therapy. This case report demonstrates a rare presentation of the non-invasive AFRS with bilateral proptosis with hypertelorism. The patient showed a drastic improvement after endoscopic sinus surgery, oral anti fungal medication, oral steroids and nasal saline irrigation.