Reports on fungal sinusitis (Paranasal Aspergillus Granuloma) in Sudan date back to 1967 when the first patient reported with unilateral proptosis was wrongly diagnosed as cancer of the eye and consequently the eye was removed. When the specimen was sent to Edinburgh University Aspergillus flavus was isolated. Because the sinus affected most was the Maxillary sinus, the histopathological reaction was typical granulomatous and the fungus isolated was an Aspergillus the term Paranasal Aspergillus Granuloma (PNAG) was used for many years. As we came to see more cases and on average about three specimens per week were received in the mycology laboratory, the clinical presentation showed more cases of, nasal polyps, maxillary swelling and unilateral proptosis. Fungi other than Aspergillus were isolated in culture or histopathology or diagnosed serologically by means of the counterimmunoelectrophoresis (CIE). WE will show a case of the maxillary sinus that spread to the orbit and brain caused by Madurella mycetomatis, a specimen from the nasal sinus and one from a nasal polyp grew Bipolaris specifera. Patients with A.flavus were treated with Itraconazole while those caused by Bipolaris specifera responded very well to Voriconazole. from...........caused by...........Mycological diagnosis is important since Itraconazole may cure the Aspergillus ones after surgery Ketoconazole is a better choice for M.mycetomatis. However in our experience with few cases, Voriconazole will cure both.
Full conference title:
18th International Society for Human and Animal Mycology
- ISHAM 18th (2012)