Secondary metabolites, 3D structure: Trivial name – Citraconic anhydride metabolite 2

Allergic fungal sinusitis (or eosinophilic fungal rhinosinusitis)

4 Total obstruction of the sinuses due to inflamed mucosa. (Patient 04)

Allergic fungal sinusitis (or eosinophilic fungal rhinosinusitis)

1 Axial computed tomography (CT) scans of the frontal sinus.
A: due to the long lasting pressure of mucus, the bone of the anterior wall of frontal sinus is thinned out and elevated anteriorly, forming a bulge. B: same situation as depicted in fig A: the posterior bony wall of frontal sinus is thinned out and extremely elevated posteriorly towards the frontal lobe of the brain. As depicted on the scan, a thin bony layer covering the dura could be recognized intraoperatively

Allergic fungal sinusitis (or eosinophilic fungal rhinosinusitis)

2 Same patient as 1 and 3, frontal CT

Allergic fungal sinusitis (or eosinophilic fungal rhinosinusitis)

3 Frontal CT

Allergic fungal sinusitis (Eosinophilic fungal rhinosinusitis)

Allergic fungal sinusitis (Eosinophilic fungal rhinosinusitis)

Plugging of airways with mucus

E. 6 months later- yellow secretions cleared after suction

Plugging of airways with mucus

D. 6 months later, tenacious yellow secretions in L basal bronchial division

Clone of Plugging of airways with mucus

C. After suction the material was seen to extend distally – obstructing the right basal stem bronchus

Plugging of airways with mucus

B. After suction the material was seen to extend distally – obstructing the right basal stem bronchus