Allergic fungal sinusitis caused by Bipolaris (Drechslera) hawaiiensis.
Eur Arch Otorhinolaryngol
; 256(7): 330-4, 1999.
Article
in En
| MEDLINE
| ID: mdl-10473824
ABSTRACT
Depending on the aggressiveness of the pathogen and a patient's immunocompetence, fungal polypoid pansinusitis or allergic fungal sinusitis (AFS) may be a life-threatening disease. Apart from the clinical findings, its diagnosis is based on the demonstration of mucinous material with abundant eosinophils in the paranasal sinuses (indicating an allergic process), cultivation of the causative pathogen and immunocompetence of the patient. In a 20-year-old immigrant Sudanese woman, AFS due to Bipolaris (Drechslera) hawaiiensis was diagnosed. Because of intracranial extension, the disease had led to erosion of the cranial base and orbit with amaurosis on the right side and focal epilepsy. In addition to endonasal microsurgical pansinus operations, local irrigation therapy with amphothericin B was accompanied by systemic treatment with itraconazole after in vitro cultivation of the pathogen and determination of its sensitivities. Interdisciplinary management included a combination of endonasal surgery with debridement of infected tissues and wide drainage of the sinuses without removal of skull bone or the dural lesion in addition to specific antimycotic treatment. Injury to adjacent anatomical structures must be avoided in any case to prevent systemic or possibly lethal dissemination of infection.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiratory Hypersensitivity
/
Sinusitis
/
Mitosporic Fungi
/
Endoscopy
Type of study:
Diagnostic_studies
Limits:
Adult
/
Female
/
Humans
Language:
En
Journal:
Eur Arch Otorhinolaryngol
Journal subject:
OTORRINOLARINGOLOGIA
Year:
1999
Document type:
Article
Affiliation country:
Germany