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Isolated sphenoid sinus lesion: A diagnostic dilemma.

Alazzawi S, Shahrizal T, Prepageran N, Pailoor J - Qatar Med J (2014)

Bottom Line: Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms.Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements.Instead, Citrobacter species was implicated to be the cause of infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

ABSTRACT
Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms. In this case report, the patient presented with a history of headaches for a duration of one month without sinonasal symptoms. A computed tomography scan showed a soft tissue mass occupying the sphenoid sinus. An endoscopic biopsy revealed fungal infection. Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements. Instead, Citrobacter species was implicated to be the cause of infection.

No MeSH data available.


Related in: MedlinePlus

Septate thick-walled fungi. Gomori methanamine stain × 400.
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fig2: Septate thick-walled fungi. Gomori methanamine stain × 400.

Mentions: The patient was admitted to the hospital. A biopsy was planned, and a transnasal endoscopic sphenoidotomy was carried out revealing greenish-white material with crustation. Histopathological examination (HPE) of the biopsy specimen revealed colonies of fungi admixed with acute inflammatory cells. Minimal superficial respiratory epithelium was noted. Gomori methenamine stain showed septate thick-walled fungi resembling mucormycosis (Figure 2). Intravenous anti-fungal treatment (Amphotericin B) was started as adjuvant therapy based on the HPE result in preparation for definitive surgical debridement.


Isolated sphenoid sinus lesion: A diagnostic dilemma.

Alazzawi S, Shahrizal T, Prepageran N, Pailoor J - Qatar Med J (2014)

Septate thick-walled fungi. Gomori methanamine stain × 400.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4197375&req=5

fig2: Septate thick-walled fungi. Gomori methanamine stain × 400.
Mentions: The patient was admitted to the hospital. A biopsy was planned, and a transnasal endoscopic sphenoidotomy was carried out revealing greenish-white material with crustation. Histopathological examination (HPE) of the biopsy specimen revealed colonies of fungi admixed with acute inflammatory cells. Minimal superficial respiratory epithelium was noted. Gomori methenamine stain showed septate thick-walled fungi resembling mucormycosis (Figure 2). Intravenous anti-fungal treatment (Amphotericin B) was started as adjuvant therapy based on the HPE result in preparation for definitive surgical debridement.

Bottom Line: Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms.Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements.Instead, Citrobacter species was implicated to be the cause of infection.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

ABSTRACT
Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms. In this case report, the patient presented with a history of headaches for a duration of one month without sinonasal symptoms. A computed tomography scan showed a soft tissue mass occupying the sphenoid sinus. An endoscopic biopsy revealed fungal infection. Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements. Instead, Citrobacter species was implicated to be the cause of infection.

No MeSH data available.


Related in: MedlinePlus