Author/Authors :
Ghosh Gopal نويسنده Departments of Environmental Science and Technology,Jessore University of Science and Technology,Jessore,Bangladesh , Sharma Brijesh نويسنده Dr. Ram Manohar Lohia Hospital, Post-graduate Institute of Medical Education and Research, New Delhi , Kamble Ulka نويسنده Department of Medicine, Dr. RML Hospital & PGIMER, New Delhi, India , Prasad Akhilandeswari نويسنده Department of Radiology , Dr. RML Hospital & PGIMER, New Delhi, India , Chowdhary Anuradha نويسنده Department of Medical Mycolgy ,Vallabh Bhai Patel Chest Institute , Institute, University Of Delhi, India
Abstract :
[Introduction]Rhizopuse Sp. are common infectious agents of invasive rhinosinusitis. Though Alternaria is known to cause allergic rhinosinusitis, invasive sinusitis because of Alternaria Sp. is rare. Coinfections with bacteria and fungus causing rhinosinusitis have been reported as have the Rhizopus infection with other fungus such as Aspergillus, Candida, and Exserohillum.However Rhizopus coinfection with Alternaria has not been reported to the best of our knowledge.[Case Presentation]A sixty-year- old woman was admitted with periorbital pain, swelling and complete restriction of movement of her right eye. She had diabetes mellitus for fifteen years. Diagnosis of invasive sinusitis was confirmed by hyperintensities in her right maxillary and bilateral ethmoid sinuses on the MRI on her brain and demonstration of hyphal forms from sinus mucosa. Culture confirmed the presence of Alternariaalternata and Rhizopus arrhizus. Patient responded to treatment with Amphotercin B and had complete resolution.[Conclusions]Co-infection with bacteria and mixed fungal infection should be looked for as treatment strategies may differ with different organisms. Presumptive treatment should include agents, which can cover the broadest possible range of organism known to cause invasive sinusitis.
