Granulomatous Invasive Infection Involving the Nasal Sinuses and Brain

Overview

Journal J Investig Med High Impact Case Rep

Specialty General Medicine

Date 2018 May 16

PMID 29761110

Citations 7

Authors

Roopam Jariwal

Arash Heidari

Ahana Sandhu

Janushe Patel

Kamelia Shoaepour

Piruthiviraj Natarajan

Everardo Cobos

Affiliations

Soon will be listed here.

Abstract

Invasive fungal infections are commonly associated with some form of immunosuppression. On the nasal epithelial surface, , under favorable conditions, can aggressively breach multiple cell lines invading the local tissues. We present the case of a 35-year-old woman with granulomatous invasive infection involving the nasal sinuses and the brain. Antifungal agents administered in the previous episodes contained the infection; however, the infected site evolved over time surrounded with calcified tissues in the left maxillary sinus. The current infection involved the other side of the maxillary sinus and extended to the orbital cavity eroding the parts of the skull and retro-orbital structures and was treated with a long course of isavuconazole therapy.

Citing Articles

Systematic Review of Granulomatous Invasive Fungal Sinusitis Management.

Baqays A, Almutawa S, Alsabti R, Alsughayer L, Campbell S, Almaflehi N Laryngoscope Investig Otolaryngol. 2025; 10(1):e70086.

PMID: 39866555 PMC: 11761710. DOI: 10.1002/lio2.70086.

Mycoviruses in Fungi: Carcinogenesis of Fungal Agents May Not Always Be Mycotoxin Related.

Tebbi C J Fungi (Basel). 2023; 9(3).

PMID: 36983536 PMC: 10052198. DOI: 10.3390/jof9030368.

"Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report".

Trevino-Gonzalez J, Santos-Santillana K, Maldonado-Chapa F, Morales-Del Angel J, Gomez-Castillo P, Cortes-Ponce J Ann Med Surg (Lond). 2021; 72:103129.

PMID: 34873446 PMC: 8636311. DOI: 10.1016/j.amsu.2021.103129.

Isavuconazole-Animal Data and Clinical Data.

Pagano L, Cattaneo C, Quattrone M, Oberti M, Mazzitelli M, Trecarichi E J Fungi (Basel). 2020; 6(4).

PMID: 33036295 PMC: 7712195. DOI: 10.3390/jof6040209.

It's all in your head: antifungal immunity in the brain.

Snarr B, Drummond R, Lionakis M Curr Opin Microbiol. 2020; 58:41-46.

PMID: 32828989 PMC: 7438209. DOI: 10.1016/j.mib.2020.07.011.

References

Underhill D, Iliev I . The mycobiota: interactions between commensal fungi and the host immune system. Nat Rev Immunol. 2014; 14(6):405-16. PMC: 4332855. DOI: 10.1038/nri3684. View

Mellon J, Cotty P, Dowd M . Aspergillus flavus hydrolases: their roles in pathogenesis and substrate utilization. Appl Microbiol Biotechnol. 2007; 77(3):497-504. DOI: 10.1007/s00253-007-1201-8. View

Mikulska M, Raiola A, Bruno B, Furfaro E, Van Lint M, Bregante S . Risk factors for invasive aspergillosis and related mortality in recipients of allogeneic SCT from alternative donors: an analysis of 306 patients. Bone Marrow Transplant. 2009; 44(6):361-70. DOI: 10.1038/bmt.2009.39. View

Lee R, Workman A, Carey R, Chen B, Rosen P, Doghramji L . Fungal Aflatoxins Reduce Respiratory Mucosal Ciliary Function. Sci Rep. 2016; 6:33221. PMC: 5021939. DOI: 10.1038/srep33221. View

Behnsen J, Hartmann A, Schmaler J, Gehrke A, Brakhage A, Zipfel P . The opportunistic human pathogenic fungus Aspergillus fumigatus evades the host complement system. Infect Immun. 2007; 76(2):820-7. PMC: 2223477. DOI: 10.1128/IAI.01037-07. View

Kanamori H, Rutala W, Sickbert-Bennett E, Weber D . Review of fungal outbreaks and infection prevention in healthcare settings during construction and renovation. Clin Infect Dis. 2015; 61(3):433-44. DOI: 10.1093/cid/civ297. View

Tieu D, Kern R, Schleimer R . Alterations in epithelial barrier function and host defense responses in chronic rhinosinusitis. J Allergy Clin Immunol. 2009; 124(1):37-42. PMC: 2802265. DOI: 10.1016/j.jaci.2009.04.045. View

Rai G, Ansari M, Dar S, Datt S, Gupta N, Sharma S . Serum Cytokine Profile in Patients with Chronic Rhinosinusitis with Nasal Polyposis Infected by Aspergillus flavus. Ann Lab Med. 2017; 38(2):125-131. PMC: 5736671. DOI: 10.3343/alm.2018.38.2.125. View

Singh A, Gupta P, Verma N, Khare V, Ahamad A, Verma V . Fungal Rhinosinusitis: Microbiological and Histopathological Perspective. J Clin Diagn Res. 2017; 11(7):DC10-DC12. PMC: 5583846. DOI: 10.7860/JCDR/2017/25842.10167. View

10.

Kern R, Conley D, Walsh W, Chandra R, Kato A, Tripathi-Peters A . Perspectives on the etiology of chronic rhinosinusitis: an immune barrier hypothesis. Am J Rhinol. 2008; 22(6):549-59. PMC: 2802263. DOI: 10.2500/ajr.2008.22.3228. View

11.

deShazo R, OBrien M, Chapin K, Gardner L, Swain R . A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1997; 123(11):1181-8. DOI: 10.1001/archotol.1997.01900110031005. View

12.

Kontoyiannis D, Marr K, Park B, Alexander B, Anaissie E, Walsh T . Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010; 50(8):1091-100. DOI: 10.1086/651263. View

13.

Man W, de Steenhuijsen Piters W, Bogaert D . The microbiota of the respiratory tract: gatekeeper to respiratory health. Nat Rev Microbiol. 2017; 15(5):259-270. PMC: 7097736. DOI: 10.1038/nrmicro.2017.14. View

14.

Sugui J, Kwon-Chung K, Juvvadi P, Latge J, Steinbach W . Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med. 2014; 5(2):a019786. PMC: 4315914. DOI: 10.1101/cshperspect.a019786. View

15.

Markaryan A, Morozova I, Yu H, Kolattukudy P . Purification and characterization of an elastinolytic metalloprotease from Aspergillus fumigatus and immunoelectron microscopic evidence of secretion of this enzyme by the fungus invading the murine lung. Infect Immun. 1994; 62(6):2149-57. PMC: 186491. DOI: 10.1128/iai.62.6.2149-2157.1994. View