Fungal sinusitis

Case contributed by Ahmed Abdrabou
Diagnosis almost certain


Recurrent attacks of headache and post nasal discharge

Patient Data

Age: 16 years
Gender: Male

Mucoperiosteal reaction of both maxillary, ethmoidal and left frontal sinuses with obliteration of both osteomeatal complexes. It exhibits variable signal intensity; on the left side the mucoperiosteal reaction displays low T1 bright T2 signal with marginal enhancement. On the right side there is low T1 yet loss of signal on T2 owing to paramagnetic effect of iron and manganese particles in fungal hyphae.

Case Discussion

T2 WI is helpful in fungal sinusitis as the presence of iron and manganese particles in mycetoma causes signal loss on T2 WI due to paramagnetic effect.

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