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Case Reports
. 2003 Oct;41(10):4885-7.
doi: 10.1128/JCM.41.10.4885-4887.2003.

Bipolaris spicifera causes fungus balls of the sinuses and triggers polypoid chronic rhinosinusitis in an immunocompetent patient

Walter Buzina  1 , Hannes Braun, Kerstin Schimpl, Heinz Stammberger
Affiliations
Case Reports

Bipolaris spicifera causes fungus balls of the sinuses and triggers polypoid chronic rhinosinusitis in an immunocompetent patient

Walter Buzina et al. J Clin Microbiol. 2003 Oct.

Abstract

We report the rare case of a 19-year-old immunocompetent male suffering both from fungus balls of the sinuses and from chronic rhinosinusitis with massive polyposis. Endoscopic sinus surgery revealed grayish brown necrotic masses embedded in viscous eosinophilic mucus. Inoculated onto petri dishes, these masses as well as the mucus grew a dark pigmented fungus, which was identified as Bipolaris spicifera.

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Figures

FIG. 1.
FIG. 1.
Axial computed tomography scans of the frontal sinus. (A) Due to the long lasting pressure of mucus, the bone of the anterior wall of frontal sinus is thinned out and elevated anteriorly, forming a bulge (white arrow). (B) The same situation as depicted in panel A is shown. The posterior bony wall of frontal sinus is thinned out and extremely elevated posteriorly toward the frontal lobe of the brain (black arrows). As shown on the scan, a thin bony layer covering the dura could be recognized intraoperatively.
FIG. 2.
FIG. 2.
Endoscopic view into the entrance to the sphenoidal sinus showing fungal masses of Bipolaris spicifera (arrow).
FIG. 3.
FIG. 3.
GMS staining of paraffin-embedded mucus showing septate, branched fungal hyphae surrounded by eosinophils within the mucus.
See this image and copyright information in PMC

References

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