Chronic invasive fungal sinusitis

Case contributed by Dr. Ekaterina Peshevich
Diagnosis probable

Presentation

Trauma patient was delivered to the emergency room to exclude skull fracture and intracranial hematoma. Complaints about nasal congestion. Clinical examination demonstrated exophthalmos and edema of the right eye.

Patient Data

Age: 25 years
Gender: Male

All parts of the paranasal sinuses are totally filled with non-uniform hyperdense mass, extending into the cavity of the nasopharynx. The bone is thin-walled with destruction of the posterior wall of the left frontal sinus, right lamina papyracea, posterior and lateral walls of the sphenoid sinus.

Abnormal soft-tissue density within the right orbital cavity. In the area of the right lacrimal gland fossa, there is a localized fluid density lesion, indenting the superior rectus muscle.

There is a possible formation of epidural abscess in the frontal lobe.

Case Discussion

The findings are more likely to represent chronic invasive fungal sinusitis with orbital cellulitis

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