ABSTRACT
Introduction: Aspergillosis is the second most frequent opportunistic fungal infection of the pa-ranasal sinuses. It primarily affects the maxillary sinus and occurs mainly in immunocompromi-sed individuals. Infection is caused by inhalation of spores or by an oro-sinusal communication. Aspergillosis is classified into an invasive and non-invasive form or Aspergilloma, which usually affects immunocompetent patients. Violaceous lesions, ulcers, necrosis and tissue destruction can be manifested clinically. Patients may experience pain, paresthesias, increases in the vo-lume of purulent or bloody nasal discharge and congestion. Case report: A 62-year-old female patient, immunocompetent, with a condition evolving for about six years. Condition began after a dental extraction, and consisted of absence of scarring and recurrent episodes of symptoma-tology suggestive of maxillary sinusitis with poor response to antibiotics. The patient was referred to the maxillofacial care unit, presenting an increase of volume in the right genial region, pain and paraesthesia of infraorbital region. The CT scan showed the presence of a radiopaque foreign body in the right maxillary sinus. A surgical procedure was carried out using the Caldwe-ll-Luc technique and biopsy; the case was diagnosed with Aspergillosis. The patient was treated without antifungal therapy because she had a good immune status. Conclusion: Aspergilloma is the most common form of Aspergillosis in immunocompetent individuals. It is usually diagnosed late, as its clinical picture is similar to bacterial sinusitis. In most cases, patients respond well to surgical treatment, and systemic antifungal therapy is not necessary.
Subject(s)
Humans , Female , Middle Aged , Aspergillosis/surgery , Aspergillosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Maxillary Sinusitis/surgery , Immunocompromised HostABSTRACT
Aspergillus is a common cause of invasive mycosis, especially in immunocompromised individuals. We report the case of a 62-year-old male who was hospitalized after suffering severe physical injuries and died after few weeks of hospitalization. A medicolegal autopsy was conducted, and various organs were sent for histopathological examination of which heart, lungs, and kidneys showed extensive involvement by aspergillus. Thus, a diagnosis of disseminated invasive aspergillosis was made on autopsy, which itself is a rare entity. This case report illustrates a prolonged stay in the intensive care unit as a possible risk factor for the development of disseminated aspergillosis.
Subject(s)
Humans , Male , Middle Aged , Aspergillosis/pathology , Multiple Trauma , Aspergillosis/diagnostic imaging , Autopsy , Cause of Death , Intensive Care Units , Respiration, ArtificialABSTRACT
The Sudan is endemic for Aspergillus species, especially Aspergillus flavus. They commonly invade the paranasal sinuses, but massive invasion of the brain in immunocompetent patients is rare. To describe the clinical presentation and MRI findings in immunocompetent patients with massive paranasal aspergillosis with extensive invasion of the brain. Four patients, who are negative for HIV and other immunocompromizing disorders were studied in this article. Two females 55 and 25 year old, 2 males 29 and 62 year old were described. All cases showed extensive invasion of the paranasal sinuses and the adjacent structures. Invasive paranasal Aspergillosis can affect immunocompetent patients and the commonest organism is Aspergillus flavus
Subject(s)
Humans , Male , Female , Aspergillosis/diagnostic imaging , Paranasal Sinus Diseases/microbiology , Paranasal Sinuses/microbiology , Brain/microbiology , Aspergillus flavus , Magnetic Resonance Imaging , ImmunocompetenceABSTRACT
Aspergillosis of the paranasal sinuses appears to be relatively rare in occurrence, but there is a growing incidence of it in accordance with the increasing use of antibiotics, steroid hormones, anticancer drugs, and radiation therapy. We have seen 15 cases of aspergillosis of the paranasal sinuses in which computed tomography (CT) was helpful for diagnosis. The characteristic feature of CT findings was the intermixture of high and low density areas in the affected paranasal sinuses, apparently caused by increased X-ray absorption due to calcification. These findings indicate that CT is useful in the preoperative diagnosis of aspergillosis of the paranasal sinuses.
Subject(s)
Adult , Female , Humans , Male , Aspergillosis/diagnostic imaging , Middle Aged , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Aspergillosis of the paranasal sinuses appears to be relatively rare in occurrence, but there is a growing incidence of it in accordance with the increasing use of antibiotics, steroid hormones, anticancer drugs, and radiation therapy. We have seen 15 cases of aspergillosis of the paranasal sinuses in which computed tomography (CT) was helpful for diagnosis. The characteristic feature of CT findings was the intermixture of high and low density areas in the affected paranasal sinuses, apparently caused by increased X-ray absorption due to calcification. These findings indicate that CT is useful in the preoperative diagnosis of aspergillosis of the paranasal sinuses.