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Fungal Sinusitis
Case Detail
| Anatomy: Neck-Face |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Infectious-Inflammatory |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
CT
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Activities:  PDF  ImageJA |
History
3 year old female being treated for leukemia presenting with facial cellulitis.
Case Images
Diagnosis
Findings
CT – Postcontrast axial images of the face with bone and standard windowing algorithms demonstrate opacification of the maxillary sinuses and destruction of the posterolateral wall of the right maxillary sinus.
Discussion
Acute invasive fungal sinusitis is a rapidly progressing infection seen predominantly in immunocompromised patients and patients with poorly controlled diabetes, but rarely in healthy individuals. It is the most lethal form of fungal sinusitis, with a reported mortality of 50%–80%. Noncontrast CT demonstrates hypoattenuating mucosal thickening or an area of soft-tissue attenuation within the lumen of the involved paranasal sinus and/or nasal cavity. There is a predilection for unilateral involvement of the ethmoid and sphenoid sinuses. Aggressive bone destruction of the sinus walls occurs rapidly with intracranial and intraorbital extension of the inflammation.
Reference
Aribandi M, McCoy V, Bazan C.Imaging Features of Invasive and Noninvasive Fungal Sinusitis: A Review. RadioGraphics, Sep 2007; 27: 1283 – 1296.