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Fungal sinusitis

Case contributed by Heba Abdelmonem
Diagnosis almost certain

Presentation

Left nasal obstruction

Patient Data

Age: 30 years
Gender: Male
ct

Complete opacification of the left, sphenoidal, ethmoidal, left maxillary sinuses by hyper-dense attenuation contents that extend to the nasal cavity via wide osteomeatal units. There is abnormal expansion and remodeling of the affected nasal cavity and sinuses with the nasal turbinates being engulfed by the lesion. Minimal erosion of the left lamina papyracea with subtle intraorbital extension. Associated erosion is seen at the roof of the ethmoidal sinus with no CT evidence of intracranial extension.

Abnormal fluid-filled frontal sinus as well as left sphenoid sinus as a result of obstruction of their draining recesses.

Right marginal maxillary mucosal thickening with obliterated osteomeatal unit.

Case Discussion

The presence of intrasinus hyperdense material favors chronic invasive fungal sinusitis.

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