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Student Project | Health and Medical Sciences | India | Volume 14 Issue 4, April 2025 | Popularity: 5.5 / 10
Maxillary Sinus Mucormycosis Presenting as a Fungal Ball in an Uncontrolled Diabetic: A Diagnostic Dilemma
Dr. N Chandana, Dr. Sudhir M Naik, Dr. Aishwarya
Abstract: Background: Mucormycosis is a rare, invasive fungal infection typically associated with immunocompromised individuals, notably those with uncontrolled diabetes. It often presents aggressively with rapid progression involving the sinonasal, orbital, or cerebral regions. However, atypical presentations can complicate diagnosis and delay treatment. Case report: We report a case of a 44-year-old woman with poorly controlled diabetes mellitus (HbA1c: 8.4%) who presented with a 5?6 year history of left-sided headache and head heaviness, recently worsened and accompanied by unilateral facial pain, foul-smelling odor from the left nasal cavity, and postnasal drip. Notably, there were no signs of nasal obstruction, discharge, or systemic symptoms. Anterior rhinoscopy and diagnostic nasal endoscopy revealed minimal findings, while imaging studies suggested maxillary sinusitis with hyperdense material indicative of a fungal ball. The patient underwent functional endoscopic sinus surgery (FESS), revealing a calcified mass in the left maxillary sinus. Initial intraoperative findings and CT features suggested a non-invasive fungal ball, often associated with Aspergillus. However, histopathology confirmed mucormycosis, showing broad, aseptate, branching hyphae with PAS positivity. Conclusion: This case underscores an unusual presentation of maxillary sinus mucormycosis mimicking a fungal ball, emphasizing the importance of considering invasive fungal infections in diabetic patients, even in the absence of classical symptoms. Timely surgical intervention and histopathological confirmation are vital for accurate diagnosis and effective management. A high index of suspicion is essential to prevent potential complications associated with delayed treatment in immunocompromised individuals.
Keywords: Mucormycosis, Fungal ball, Maxillary sinusitis, Diabetes mellitus, Invasive fungal sinusitis, Chronic headache, Posaconazole, Functional endoscopic sinus surgery (FESS), Histopathology, Atypical presentation, Calcified sinus mass, Immunocompromised host, Fungal rhinosinusitis, Diagnostic dilemma, Sinonasal infection
Edition: Volume 14 Issue 4, April 2025
Pages: 599 - 601
DOI: https://www.doi.org/10.21275/SR25406202139
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