Kosin Med J.  2011 Dec;26(2):183-189.

A Case of Invasive Aspergillosis of the Paranasal Sinuses Treated with Surgery and Voriconazole after Kidney Transplantation

• Shin HS
• Lee SJ
• Jung YS
• Rim H

Abstract

Invasive fungal sinusitis is a rare, severe disease, most commonly presenting in immunocompromised patients who have impaired neutrophil function or who have received long term immunosuppressive therapy. The gold standard for treatment has been wide surgical debridement, intravenous administration of antifungal agents such as amphotericin B (AMB), and correction of the underlying immunocompromised state. A 51-year-old female was admitted to our hospital with fever and headache who had received renal transplantation 14 years ago in the other hospital. Paranasal sinus CT scan revealed hyperplasia and soft tissue density of the left maxillary sinus. Histological examination of the fungus ball and edematous mucosa of the left maxillary sinus revealed suspicious invasion of Aspergillus in the mucosa. Clinical improvement occurred after a combination of surgery and post-operative systemic antifungal therapy with voriconazole. We think that voriconazole as initial treatment may be initiated for invasive sinonasal aspergillosis, if the infection is known to be due to Aspergillus species.

Keyword

Aspergillosis; Kidney transplantation; Sinusitis; Voriconazole

MeSH Terms

Administration, Intravenous
Amphotericin B
Antifungal Agents
Aspergillosis
Aspergillus
Debridement
Female
Fever
Fungi
Headache
Humans
Hyperplasia
Immunocompromised Host
Kidney
Kidney Transplantation
Maxillary Sinus
Middle Aged
Mucous Membrane
Neutrophils
Paranasal Sinuses
Pyrimidines
Sinusitis
Triazoles
Amphotericin B
Antifungal Agents
Pyrimidines
Triazoles