Presentation of invasive fungal rhinosinusitis in Sudanese children: a report of four cases

Abstract

Fungal rhinosinusitis (FS) is considered as a disease spectrum that ranges from allergic fungal sinusitis (AFS) and chronic fungal rhinosinusitis (CFS) to invasive fungal rhinosinusitis (IFS) invading the orbit, Dura, and intra-cranium. Fungal rhinosinusitis is a common disease in Sudan.

Objective: To present four rare cases of Invasive Fungal Rhinosinusitis in Sudanese children presented with orbital extension.

Patients and Method: The authors have reported four cases of children in the age range of 9–11 years, two girls and two boys; they were presented with invasive fungal rhinosinusitis in Africa ENT hospital (Sudan) during the period from September 2015 to August 2017. Patients’ diagnosis was made by endoscopic examination, CT, and MRI, and it was confirmed by tissue biopsy.

Results: Patients’ age range was 9–11 years, two girls and two boys. The unilateral disease was the commonest type. An orbital extension was detected in all cases on CT and MRI. No intracranial extension was detected. Aspergillus flavus was the most responsible agent detected in all the four cases.

Conclusion: Fungal rhinosinusitis (FS) is a common disease in adult Sudanese patients but rarely affects children. It is mainly caused by Aspergillus species. The disease is extensive and can be associated with orbital and intracranial complications.

Keywords: fungal rhinosinusitis, children, Sudan