Paranasal sinus fungus balls

Abstract

Background. Paranasal sinus fungus balls (mycetomas) are a form of fungal sinus infection distinct from allergic fungal sinusitis, fulminant invasive fungal disease, and paranasal aspergillus granulomas.Methods. The Mayo Clinic surgical pathology files of inflammatory sinus specimens from 1984 to 1994 were examined. Twenty-nine paranasal sinus fungus balls were identified. Cases of allergic fungal sinusitis and invasive fungal disease were excluded.Results. The fungus balls occurred in 11 men and 18 women, with an age range of 28 to 86 years, mean 64 years. Sinuses involved included maxillary (20 cases), sphenoid (10 cases), ethmoid (9 cases), and frontal (6 cases). In 12 patients, multiple sinuses were involved in a variety of combinations. By culture the most common pathogens were Aspergillus fumigatus and Aspergillus flavus. Treatment was by a variety of surgical procedures. Follow-up in 28 patients showed two recurrences and three deaths due to intracerebral bleed as a complication of surgery. These deaths occurred in patients with sphenoid sinus fungus balls.Conclusions. Paranasal sinus fungus balls occur in an elderly population and have a female predominance. They have a low morbidity and recurrence rate. Death can occur in sphenoid sinus lesions as a complication of surgery.

Aspergillus flavus: human pathogen, allergen and mycotoxin producer

“…In these cases from India, A. flavus was the only pathogen identified (Thakar et al, 2004). Sinus aspergilloma (fungus ball) is also usually caused by A. fumigatus and such infections caused by A. flavus are less frequent in developed countries (Milosev et al, 1969;Stammberger et al, 1984;Ferreiro et al, 1997). Again, A. flavus is more commonly isolated from patients in India, Sudan and other tropical countries (Panda et al, 1998;Yagi et al, 1999;Chakrabarti et al, 1992;Milosev et al, 1969).…”

Isolated fungus ball mimicking mucocele or frontal sinus tumour: a diagnostic pitfall

“…Our first patient's symptoms were considered to indicate a possible frontal sinus mucocele, since frontal headache, fullness in the forehead and upper eyelid region, nasal Babinski et al 6 1 Bhalla et al 7 1 Chen & Chen 8 1 Dufour et al 2 4 Ferreiro et al 9 2 Gupta et al 10 1 Klossek et al 11 2 Kodama et al 12 1 Kumar et al 13 1 Panda & Reddy 14 2 Sekula et al 15 1 Stevens 16 1 Swoboda & Ullrich 4 1 Warder et al 17 1 Total 20 CLINICAL RECORD discharge, and obstruction are the most frequent clinical manifestations of this disease. 20 However, this patient's absence of previous trauma or surgery made this diagnosis unlikely.…”

Infección rinosinusal por Scedosporium apiospermum en un hospedero inmunocompetente

“…Se describe que la bola fúngica en cavidades paranasales se presenta más frecuentemente en población de mayor edad y en mujeres 7 . Los cultivos microbiológicos son habitualmente negativos, sólo en 23 a 50% de los casos se logra desarrollo micótico, hecho que se atribuye a una pobre viabilidad de los hongos al interior de la bola fúngica 1,8 .…”

“…Los cultivos microbiológicos son habitualmente negativos, sólo en 23 a 50% de los casos se logra desarrollo micótico, hecho que se atribuye a una pobre viabilidad de los hongos al interior de la bola fúngica 1,8 . El hongo identificado con mayor frecuencia, considerando cultivo y técnicas de biología molecular, es Aspergillus fumigatus 7,9,10 ; otros hongos ocasionalmente encontrados son S. apiospermum (P. boydii), Aspergillus flavus, Aspergillus niger y Aspergillus terreus 1 . Sin embargo, se debe considerar que este hongo crece bien en agar Sabouraud glucosa, agar sangre y agar chocolate, siendo recomendados medios selectivos, como agar Leonian modificado o agar ciclo-heximida, cuando se trabaja muestras respiratorias, que pudiesen contener otros hongos de más rápido crecimiento 11 .…”