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ACUTE INVASIVE FUNGAL SINUSITIS IN PATIENTS WITH DIABETES MELLITUS
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Abstract
Fungal rhinosinusitis has many different clinical forms, in which acute invasive fungal form is rare, so it is easy to misdiagnose with malignancies. Clinical case: A 68-year-old female patient with a history of diabetes presents with fever and pain in the left maxillary sinus. Initial diagnosis was acute sinusitis with Aspergillus superinfection and endoscopic sinus surgery. After surgery, the patient was given high-dose antibiotics and anti-fungal drugs, but the disease progressed worse, appeared symptoms of cranial nerve paralysis and severe headache. Imaging tests suspected nasopharyngeal cancer, but the final diagnosis was acute invasive fungal sinusitis by nasopharyngeal biopsy. Despite taking Amphotericin B, the patient still died from fungi invading the skull base and leukopenia due to bone marrow suppression. Conclusion: Mastering the symptoms, clinical signs and diagnostic criteria helps clinicians make a quick diagnosis and timely treatment, significantly reducing mortality.
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Keywords
rhinosinusitis, Aspergillus, acute, invasive, diabetes
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