Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder
Sphenoid sinus fungal ball (FB) is a noninvasive fungal infection affecting predominantly immunocompetent middle-aged female patients. Common clinical manifestations include headaches, postnasal drip, and nasal discharge. In this case report, we present a 56-year-old female with a 10-year history of...
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doaj-562a0ed7a91b439c8734d3fb3689d1392021-02-21T04:32:19ZengElsevierRadiology Case Reports1930-04332021-04-01164789794Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorderAli Guy, Clinical Assistant Professor0Angela Guy, Phd1Masum Rahman2Marina Kokova3Azizjon Abdurakhimov4Azaliia Persits5Kristi Saliaj6Ina Kola7Anisa Cobo8Juna Musa, MD, MSc9Department of Physical Medicine and Rehabilitation, New York University, School of Medicine, NYU Medical Center, New York, NY, USAHealth Emphasis California School of Professional Psychology Alliant International University, Los Angeles, CA, USADepartment of Neurosurgery Mayo Clinic, Rochester, MN, USANYU Langone Hospital Brooklyn, New York, NY, USAPARS Pain and Rehabilitation Services Brooklyn, New York, NY, USATraining, New York, NY, USAMother Tereza Hospital, Tirana, AlbaniaDepartment of Burns and Plastic, Tirana, AlbaniaMother Tereza Hospital, Tirana, AlbaniaPhysiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA; Corresponding author.Sphenoid sinus fungal ball (FB) is a noninvasive fungal infection affecting predominantly immunocompetent middle-aged female patients. Common clinical manifestations include headaches, postnasal drip, and nasal discharge. In this case report, we present a 56-year-old female with a 10-year history of occasional dizziness, vertigo, nystagmus, feeling disoriented and feeling her eyes moving rapidly. Complaints of restlessness, insomnia, anxiety, stress and anger were also present. Due to the nonspecific nature of her symptoms, a diagnosis of sphenoid sinus FB was overlooked. Definitive diagnosis was established after performing a nasal endoscopy and subsequent histopathological examination of the collected sinus tissues. The histopathology report disclosed Aspergillosis FB with chronic sinusitis. Due to the decade long delay in diagnosis and proper treatment, septal wall collapse occurred, with the patient developing diabetes insipidus with hyponatremia that led to a massive seizure and fall, resulting in multiple disc herniations. Surgical removal of the FA elicited a complete resolution of her symptoms and a full recovery.Although fungal rhinosinusitis is a well recognized spectrum of diseases by ENT specialists, through this case report we hope to draw attention to this particular pathological entity within fungal infections, while simultaneously underlining the broad spectrum of symptoms with which it may manifest and the importance of including FA infections when considering the differential diagnosis in patients with long-standing chronic sinusitis.http://www.sciencedirect.com/science/article/pii/S1930043321000303Fungal ballChronic rhinosinusitisFungal rhinosinusitisSphenoid sinusAspergillus spp |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ali Guy, Clinical Assistant Professor Angela Guy, Phd Masum Rahman Marina Kokova Azizjon Abdurakhimov Azaliia Persits Kristi Saliaj Ina Kola Anisa Cobo Juna Musa, MD, MSc |
spellingShingle |
Ali Guy, Clinical Assistant Professor Angela Guy, Phd Masum Rahman Marina Kokova Azizjon Abdurakhimov Azaliia Persits Kristi Saliaj Ina Kola Anisa Cobo Juna Musa, MD, MSc Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder Radiology Case Reports Fungal ball Chronic rhinosinusitis Fungal rhinosinusitis Sphenoid sinus Aspergillus spp |
author_facet |
Ali Guy, Clinical Assistant Professor Angela Guy, Phd Masum Rahman Marina Kokova Azizjon Abdurakhimov Azaliia Persits Kristi Saliaj Ina Kola Anisa Cobo Juna Musa, MD, MSc |
author_sort |
Ali Guy, Clinical Assistant Professor |
title |
Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
title_short |
Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
title_full |
Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
title_fullStr |
Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
title_full_unstemmed |
Unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
title_sort |
unusual case presentation of fungal ball infection causing diabetes insipidus and seizure disorder |
publisher |
Elsevier |
series |
Radiology Case Reports |
issn |
1930-0433 |
publishDate |
2021-04-01 |
description |
Sphenoid sinus fungal ball (FB) is a noninvasive fungal infection affecting predominantly immunocompetent middle-aged female patients. Common clinical manifestations include headaches, postnasal drip, and nasal discharge. In this case report, we present a 56-year-old female with a 10-year history of occasional dizziness, vertigo, nystagmus, feeling disoriented and feeling her eyes moving rapidly. Complaints of restlessness, insomnia, anxiety, stress and anger were also present. Due to the nonspecific nature of her symptoms, a diagnosis of sphenoid sinus FB was overlooked. Definitive diagnosis was established after performing a nasal endoscopy and subsequent histopathological examination of the collected sinus tissues. The histopathology report disclosed Aspergillosis FB with chronic sinusitis. Due to the decade long delay in diagnosis and proper treatment, septal wall collapse occurred, with the patient developing diabetes insipidus with hyponatremia that led to a massive seizure and fall, resulting in multiple disc herniations. Surgical removal of the FA elicited a complete resolution of her symptoms and a full recovery.Although fungal rhinosinusitis is a well recognized spectrum of diseases by ENT specialists, through this case report we hope to draw attention to this particular pathological entity within fungal infections, while simultaneously underlining the broad spectrum of symptoms with which it may manifest and the importance of including FA infections when considering the differential diagnosis in patients with long-standing chronic sinusitis. |
topic |
Fungal ball Chronic rhinosinusitis Fungal rhinosinusitis Sphenoid sinus Aspergillus spp |
url |
http://www.sciencedirect.com/science/article/pii/S1930043321000303 |
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