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Unusual association of diseases/symptoms
CASE REPORT
Non-invasive fungal sinusitis resulting in multiple cranial nerve neuropathies
  1. Thomas Hendriks,
  2. Samuel Leedman,
  3. Mark Quick and
  4. Aanand Acharya
  1. Department of Ear, Nose & Throat Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
  1. Correspondence to Dr Thomas Hendriks, thomas.hendriks{at}health.wa.gov.au

Abstract

A 33-year-old man presented to the emergency department with a right-sided facial paralysis and maxillary division (V2, trigeminal nerve) paraesthesia. He had been suffering with upper respiratory tract symptoms in the preceding 2 months, including rhinorrhoea, fever and headache. The patient was otherwise fit and immunocompetent. Urgent radiological investigation revealed extensive fungal sinusitis with sphenoid sinus dehiscence and skull base osteitis. The patient underwent emergency endoscopic sinus surgery revealing concretions and debris in the ethmoid and sphenoid sinuses. He was commenced on systemic antifungal therapy and made a full recovery with resolution of his cranial neuropathies. The fungus Schizophyllum commune was isolated and is a rare cause of fungal sinusitis, but with the potential for invasive disease in immunosuppressed individuals.

  • ear, nose and throat
  • ear, nose and throat/otolaryngology
  • otolaryngology / ENT

https://doi.org/10.1136/bcr-2018-229094

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    Footnotes

    • Contributors TH admitted the patient with assistance from SL and MQ, and prepared the manuscript. AA was the operating surgeon and admitting consultant for the patient.

    • 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.

    • Competing interests None declared.

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

    • Patient consent for publication Obtained.