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Skull base osteitis following fungal sinusitis

Published online by Cambridge University Press:  29 June 2007

Andrew C. Swift  and
David W. Denning
Andrew C. Swift*
Affiliation:
Department of Otolaryngology, Aintree Hospitals Trust – Walton, Liverpool and the Department of Infectious Diseases, North Manchester General Hospital, Manchester, UK.
David W. Denning
Affiliation:
Department of Otolaryngology, Aintree Hospitals Trust – Walton, Liverpool and the Department of Infectious Diseases, North Manchester General Hospital, Manchester, UK.
*
Address for correspondence: Mr A. C. Swift, Consultant Otorhinolaryngologist, Aintree Hospital Trust – Walton, Rice Lane, LiverpoolL9 1AE. Fax: 0151 529 4033
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Abstract

Aspergillus sp. sinusitis is not uncommon in immunocompromised patients but is unusual in patients who are not immunocompromised. The disease may occur as a saprophytic condition, as an allergic sinusitis or as a potentially lethal invasive disease. The differentiation between non-invasive and invasive Aspergillus sp. sinusitis is crucial and this distinction is fully discussed. The treatment options are also considered. Invasive disease requires aggressive treatment with long-term antifungal agents in sufficient doses combined with wide surgical excision.

We present a patient who presented with invasive Aspergillus fumigatus sinusitis and subsequently developed cranial neuropathies and skull base osteitis. She was initially treated with oral itraconazole (400 mg daily) for 18 months but due to lack of response this was changed to a new experimental oral azole (voriconazole) which was continued for a further 14 months. She has since remained well for the last five years.

Keywords

Fungal sinusitisAspergillus
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 1 , January 1998 , pp. 92 - 97
Copyright
Copyright © JLO (1984) Limited 1998

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