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  • Isolated invasive fungal sphenoid sinusitis-induced extensive bone erosion and severe meningoencephalitis: diagnosis and multidisciplinary management

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Case Reports: Unusual association of diseases/symptoms
Isolated invasive fungal sphenoid sinusitis-induced extensive bone erosion and severe meningoencephalitis: diagnosis and multidisciplinary management
  1. Bassel Hallak1,
  2. Pedro Teiga1,
  3. Abderrahmane Hedjoudje2 and
  4. Vincent Alvarez3
  1. 1Department of Otorhinolaryngology, Head and Neck Surgery, Sion Hospital, Sion, Switzerland
  2. 2Department of Radiology, Sion Hospital, Sion, Switzerland
  3. 3Deaprtment of Neurology, Sion Hospital, Sion, Switzerland
  1. Correspondence to Dr Bassel Hallak; bassel.hallak{at}hopitalvs.ch

Abstract

Invasive fungal sinusitis (IFS) is more common in immunosuppressed patients but can also occur in immunocompetent hosts. While the non-invasive type of fungal sinusitis has usually a good prognosis, IFS is a potentially lethal condition.

We report the case of a woman in her 60s presenting an isolated fungal infection by Aspergillus fumigatus of the right sphenoid sinus, causing extensive bone erosion of its walls and complicated by severe meningoencephalitis. She was healthy without any immunosuppressive conditions. Methods of diagnosis, multidisciplinary management, follow-up and outcomes are documented.

Early-stage diagnosis of sphenoid sinus pathologies is often delayed because patients are usually asymptomatic. IFS of the sphenoid is more aggressive than other paranasal sinus and carries significant mortality. Early diagnosis and aggressive and multidisciplinary treatment are crucial to reduce sequels and improve patient’s survival.

  • Ear, nose and throat
  • Infections
  • Neurology (drugs and medicines)
  • Epilepsy and seizures
  • Surgery

https://doi.org/10.1136/bcr-2022-253788

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    Footnotes

    • Contributors BH: corresponding author and reporting. VA: reporting and investigations. PT: data acquisition and design. AH: data acquisition.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.