Beruflich Dokumente
Kultur Dokumente
Cade Martin, MD
Fungal Sinusitis
400,000 known fungal species or which 400 are human pathogens and 50 of which cause systemic or CNS infection Clinical presentation, imaging features, and treatment differ based on type of fungal sinusitis Broadly categorized into invasive and noninvasive
Fungal Sinusitis
Invasive
Presence of fungal hyphae within the mucosa, submucosa, bone, or blood vessels of the paranasal sinuses
Noninvasive
Absence of fungal hyphae within the mucosa and other structures of the paranasal sinuses
Noninvasive
Allergic Fungal Sinusitis Fungus Ball (fungus mycetoma)
Unilateral ethmoid involvement with bone destruction, intraorbital spread and proptosis
Aspergillus involving the sphenoid sinus with invasion of the left cavernous sinus, thrombosis, extension to the left sylvian fissure and infratemporal fossa with cerebral infarctions.
Aspergillus in left maxillary sinus with extension anterior and posterior to the retroantral space. There is diffuse involvement of the muscles of mastication.
Moderately high T1 signal, low T2 signal with expanded sinus can be seen in allergic fungal sinusitis, mucocele, or sinonasal polyposis
Fungus Ball
Older individuals, female>male Immunocompetent Asymptomatic or minimal symptoms with chronic pressure or nasal discharge Cacosmia (perception of foul odor when no such odor exists)
Fungus Ball
Mass within the lumen of paranasal sinus and is usually limited to one sinus Frontal sinus most common followed by sphenoid sinus Noncontrast CT hyperattenuating mass often with punctate calcifications MRI variable T1 and hypointense T2 due to absence of free water, calcifications and paramagnetic metals also generate decreased T2 signal no central enhancement to differentiate from neoplasm
Fungus Ball - CT
High density material with thickened walls of the maxillary sinus due to chronic inflammation