Curvularia Lunata Infection Can Invade Orbit From Maxillary Sinus

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Curvularia Lunata Infection Can Invade Orbit From Maxillary Sinus A

DGReview of : " Invasive allergic fungal sinusitis "

Swiss Medical Weekly

09/18/2000

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A case of curvularia lunata fungal infection invading the orbit from

the right maxillary sinus is reported in the journal Swiss Medical

Weekly.

This is the first reported case of curvularia lunata invading the

orbit, according to the authors. Orbital invasions by other

dematiaceous fungi have been reported.

In this case, a 28-year old man presented with chronic sinusitis. He

complained of impaired taste, smell and right-sided epistaxis when

blowing his nose. The patient had a history of allergic rhinitis.

Examination revealed a reddish, blood covered nasal mucosa with

yellow-colored crusts. The patient's white blood count contained

nine per cent eosinophils.

Computerized tomography of the patient's head showed pansinusitis

with a mass of soft tissue in the right maxillary sinus that had

begun to invade the right orbit.

Surgery was utilized to remove the mass. On histological examination

the tissue was found to be eosinophil-rich mucoid material. Bone

necrosis and remodeling were present.

A fungal culture revealed the presence of curvularia lunata. Skin

prick and radio-allergosorbent tests for curvularia lunata were also

positive.

Levels of serum immunoglobulin E and eosinophilic cationic protein

were also elevated.

" Our patient had allergic fungal sinusitis, " the authors report, " a

heavily underdiagnosed condition. " The patient's prognosis is good.