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Rhinocerebral aspergillosis

  • Mohan Kameswaran (a1), Abdulla Al-Wadei (a1), Praful Khurana (a2) and B. C. Okafor (a1)

Abstract

Aspergillosis is increasingly being recognised as a common fungal infection of the paranasal sinuses. Although the disease is almost endemic in neighbouring Sudan, there are few reported cases from the Kingdom of Saudi Arabia. We report four cases of sinus aspergillosis with involvement of the skull bases and/or intracranial spread; a condition we have termed rhinocerebral aspergillosis. Invasive aspergillosis in our subgroup of patients occurs in otherwise healthy patients with normal immune status, quite unlike most reported cases in the western literature. The causative agent in all our patients was identified as aspergillus flavus, similar to patients reported from Sudan. This is again at variance with the case reports from other geographical locations, where aspergillus fumigatus is the commonest causative agent. Saudi Arabia would appear to represent a distinct geographical enclave, together with Sudan, where rhinocerebral aspergillosis of the sinuses and skull base may be more common than has previously been realised.

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Corresponding author

Assistant Professor, College of Medicine, P.O. Box 641, King Saud University, Abha, Saudi Arabia.

References

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Adams, N. F. (1933) Infections involving the ethmoid, maxillary and sphenoid sinuses and the orbit due to aspergillus fumigatus. Archives of Surgery, 26: 999
Arora, M. M. L., Iqbal, S. M. D., Rashid, A., Mehera, Y. N.Talwar, P. (1978) Aspergillosis of the paranasal sinuses and pharynx. Estratto da Minerva Oiorinolaringologica, 28, 123127.
Cheesman, A. D., Lund, V. J., Howard, D. J. (1986) Craniofacial resection for tumours of the nasal cavity and paranasal sinuses. Journal of Head and Neck Surgery, 8, 429439.
Clissold, S. P. (1987) Clinical experience in systemic and subcutaneous mycoses—in Ketoconazole Today: (Jones, H. E., ed.), ADIS Press Ltd., Manchester, p 73.
Dawlatly, E. E., Anim, J. T.Sowayan, S., El Hassan, A. Y. (1988) Primary paranasal aspergillus granuloma in Saudi Arabia. Tropical Geographical Medicine, 40, 247250.
Hartwick, R. W.. Batsakis, J. G. (1991) Pathology Consultation: sinus aspergillosis and allergic fungal sinusitis. Annals of Otology, Rhinology and Laryngology, 100, 427430.
Jahrsdoerfer, R. A., Ejercito, V. S., Johns, M. M. E., Cantrell, R. W., Syndor, J. B. (1979) Aspergillosis of the nose and paranasal sinuses. American Journal of Otolaryngology, 1: 614.
Katzenstein, A. A., Sale, S. R., Greenberger, P. A. (1983) Allergic aspergillosis sinusitis: A newly recognized form of sinusitis. Journal of Allergy and Clinical Immunology, 72, 8993.
Mahgoub, El Sheikh. (1971) Mycological and serological studies on aspergillus flavus isolated from paranasal aspergilloma in Sudan. The Journal of Tropical Medicine and Hygiene, 74, 162165.
Mahgoub, El Sheikh. (1977) Mycoses of the Sudan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 71, 184187.
McGill, T. J., Simpson, G., Healy, G. B. (1980) Fulminant aspergillosis of the nose and paranasal sinuses: A new clinical entity. Laryngoscope, 90, 748754.
Milosev, B., Mahgoub, El Sheikh, Aal, A., Hassan, El A. M. (1969) Primary aspergilloma of the paranasal sinuses in the Sudan: A review of seventeen cases. British Journal of Surgery, 56, 132137.
Quiney, R. E., Rogers, M. J. C.Davidson, R. N., Cheesman, A. D. (1988) Craniofacial resection for extensive paranasal sinus aspergilloma. Journal of Laryngology and Otology, 102, 11721175.
Robb, P. J. (1986) Aspergillosis of the paranasal sinuses: A case report and histological perspective. Journal of Laryngology and Otologyy, 100, 10711077.
Romett, J. L., Newman, R. K. (1982) Aspergillosis of the nose and paranasal sinuses. Laryngoscope, 92: 764766.
Stammberger, H., Jakse, R., Beaufort, F. (1984) Aspergillosis of the paranasal sinuses: X-ray diagnosis, histopathology and clinical aspects. Annals of Otology Rhinology and Laryngology, 93, 251256.
Waxman, J. E., Spector, J. G., Sale, S. R., Katzenstein, A. A. (1987) Allergic aspergillus sinusitis: concepts in treatment of a new clinical entity. Laryngoscope, 97, 261266.
Zinemann, H. H. (1972) Sino-orbital aspergillosis: report of a case and review of the literature. Minnesota Medicine, 55, 661664.

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