Sinusitis (Fungal)

Etiology

  • Mucor or aspergillous
  • Overall uncommon

Risk Factors

  • Diabetic (in particular if poorly controlled), elderly and/or otherwise compromised hosts (e.g. chemotherapy, immune-modulating treatments)

Symptoms

  • Persistent and progressive facial pain
  • Fever and congestion
  • Invasive infection suggested by neurologic symptoms: numbness, double vision, dilated pupil (e.g. if cavernous sinus involvement/thrombosis)
  • High mortality as these organisms are rapidly invasive and hosts typically compromised

Physical Exam Findings

  • May be quite ill as it's invasive
  • Sometimes febrile, sinus area pain
  • Sometimes evidence palatal or external necrosis over sinus
  • Invasive infection suggested by neurologic findings: facial numbness, dilated pupil, impaired extra-occular movements, red eye (e.g. w/cavernous sinus thrombosis)
  • Impaired trans-illumination of maxillary sinus (if affected)

Tests