Chronic Granulomatous Invasive Fungal Sinusitis: A Case Series and Literature Review

Ear Nose Throat J. 2021 Sep;100(5_suppl):720S-727S. doi: 10.1177/0145561320904620. Epub 2020 Feb 20.

Abstract

Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species (Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

Keywords: Aspergillus; allergic fungal; granulomatous; invasive fungal; sinusitis; voriconazole.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Antifungal Agents / therapeutic use
  • Chronic Disease
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures
  • Debridement
  • Endoscopy
  • Fatal Outcome
  • Female
  • Granuloma / diagnosis*
  • Granuloma / therapy*
  • Humans
  • Invasive Fungal Infections / diagnosis*
  • Invasive Fungal Infections / therapy*
  • Male
  • Sinusitis / diagnosis*
  • Sinusitis / therapy*

Substances

  • Antifungal Agents