A Study on the Diagnosis of Fungus Ball

ABSTRACT

BACKGROUND: Fungus ball should always be considered in the differential diagnosis of chronic or recurrent sinusitis resistant to adequate medicinal treatment. MATERIALS AND METHODS: From January 1, 1995, to September 31, 1997, 32 patients were diagnosed with fungus ball based on the pathologic confirmation. We reviewed the 32 patients from the diagnostic point of view, evaluating clinical symptoms, signs, computerized tomography (CT) findings, and operative findings. We also reviewed five cases of clinical misdiagnosis, in which pathologic confirmation failed to identify fungus despite operative and radiologic findings suggesting its presence. RESULTS: Among 32 patients, 19 cases (59%) were suspected prior to surgery as having fungus ball. Eleven cases (34%) were suspected only upon historical and physical examination. CONCLUSION: A high index of suspicion is necessary for the diagnosis of fungus ball. A pathologic confirmation is necessary for a definite diagnosis.