Diagnostic dilemma in a case of chronic invasive fungal sinusitis solved using a novel diagnostic test

Fungal infections of the paranasal sinuses are a spectrum of diseases rather than one distinct entity. The prevalence of fungal sinus disease has been increasing in recent decades, especially in immunocompetent individuals. The indiscriminate use of antibiotics and immunosuppressive drugs has partially been attributed to this. The diagnosis of invasive fungal disease still imposes a challenge to medical professionals occasionally. Here we present an interesting case of a middle-aged immunocompetent male who presented to us with non-specific symptoms of chronic invasive fungal sinusitis. The routine investigations for diagnosing fungal sinusitis turned out to be futile and the result of serum galactomannan test helped to identify and treat his condition. <p> </p>

A case of pelvic actinomycosis affecting genital, urinary and digestive tracts: a rare misleading diagnosis

Pelvic actinomycosis is an uncommon chronic invasive disease caused by a bacteria of the Actinomyces spp. Its diagnosis constitutes a clinical challenge and is usually reached in the postoperative period after resecting a pelvic mass that usually mimics advanced ovarian cancer. Although pelvic actinomyocosis involving the digestive and genital tract has been commonly described, very few reports have described cases involving both ovaries and requiring partial cystectomy for bladder involvement. Herein, we illustrate a case of pelvic actinomycosis with extensive involvement of multiple pelvic organs, misleading the surgeon into undergoing a complete clearance of the wrongfully thought adnexal malignancy.

Chronic Invasive Fungal Sinusitis With Negative Histopathology: A Diagnostic Challenge

Although the diagnosis of chronic invasive fungal sinusitis relies chiefly on identification of invasive fungi on histology, the insidious nature of the disease can preclude detection of fungal organisms. Here, we present a case of chronic invasive fungal sinusitis with negative histopathologic findings and a definitive diagnosis made through fungal DNA detection. Clinicians should consider polymerase chain reaction an important complement to histology and culture in the diagnosis of chronic invasive fungal sinusitis.