Blindness from Fungal Rhinosinusitis of the Paranasal Sinuses: A Case Report

  • Daniel Rico T. De Jesus, MD Department of Otorhinolaryngology Head and Neck Surgery Jose R. Reyes Memorial Medical Center
  • Patrick Joseph L. Estolano, MD Department of Otorhinolaryngology Head and Neck Surgery Jose R. Reyes Memorial Medical Center
Keywords: sinusitis, blindness, sphenoid sinus, maxillary sinus, pregnancy

Abstract

ABSTRACT

Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Patient: One

Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of  binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted.

Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.

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Published
2020-12-01
How to Cite
1.
De Jesus DR, Estolano PJ. Blindness from Fungal Rhinosinusitis of the Paranasal Sinuses: A Case Report. Philipp J Otolaryngol Head Neck Surg [Internet]. 2020Dec.1 [cited 2021Jan.27];35(2):41. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1515