MUCORMYCOSIS WITH FUNGAL BALL OF MAXILLARY SINUS – A RARE STUDY

Abstract

Background and Aim: Mucormycosis is an infection caused by a group of filamentous molds within the order Mucorales. In developing countries, most cases occur in persons with poorly controlled diabetes mellitus or following trauma. Mortality associated with invasive mucormycosis is high (> 30–50%). Noninvasive fungal ball, a matted  collection of fungal hyphae, previously known as 'Aspergillomas', has been rarely reported with Mucoraceaespecies. Case presentation: A 52-year-old man, known case of diabetes mellitus presented with a discharging sinus in left maxillary region and a blackish ulcer in Left molar region. Computed tomography scan revealed extensive cortical erosion of  left hemi-maxilla. Mucormycosis infection with a maxillary sinus fungal ball was confirmed on histopathological examination. The patient was treated with intravenous AmphotericinB. Discussion: The incidence of fungal rhinosinusitis (FRS), once thought to be a rare condition, has dramatically increased recently. Acute invasive fungal rhinosinusitis is relatively rare that is frequently observed in immunocompromised people specifically uncontrolled diabetics or people on immunosuppressive medications, typically associated with Aspergillus and Mucoraceae species. On the other hand, a fungal ball of the paranasal sinus is noninvasive and typically found in immunocompetent, non-atopic hosts. Aspergillus species are the most commonly isolated fungi, however, fungal ball formation is rarely seen with mucormycosis. Conclusion: An anomalous presentation of a Fungal Ball associated with mucormycosis is the primary focus of this report