Fungal Rhinosinusitis

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• Invasive fungal sinusitis - common in immunosuppressed such as diabetic (uncontrolled, Ketoacidosis)
• This is an aggressive soft tissue infection with a high mortality rate and needs a high index of suspicion.
• Early referral to Ear, Nose and Throat surgeon is required.

Presentation

• Nasal blockage, necrosis of mucosa of nasal cavity.
• Orbital signs include proptosis and opthalmoplegia.
• Patients may also present with intracranial extension. 

Management

Refer for:

• Correct underlying cause
• Aggressive surgical debridement
• Microscopy and culture to identify the fungus
• Systemic antifungal treatment