ArticleInternational journal of surgery case reports2026
Sphenoid fungal rhinosinusitis across the disease spectrum: a case series of non-invasive fungal ball and fatal acute invasive fungal rhinosinusitis.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Sphenoid fungal rhinosinusitis is an uncommon but clinically important entity ranging from non-invasive fungal ball to rapidly fatal acute invasive fungal rhinosinusitis. Case presentation: We report two contrasting cases of sphenoid fungal disease. The first was a 28-year-old immunocompetent woman with chronic unilateral refractory headache caused by an isolated sphenoid fungal ball, which was successfully treated with endoscopic sphenoidotomy and clearance. The second was a 49-year-old man with diabetes mellitus who presented with orbital involvement, cavernous sinus thrombosis, and fungal encephalitis due to an invasive Rhizopus infection, despite urgent debridement and systemic amphotericin B, with a fatal outcome. Discussion: These cases illustrate how sphenoid fungal disease may present either as an isolated refractory headache in an otherwise healthy patient or as a fulminant invasive infection in a high-risk host. Early imaging, endoscopic assessment, and timely differentiation between non-invasive and invasive disease are essential because management and prognosis differ markedly. Conclusion: The paired presentation highlights key red flags for early diagnosis and emphasizes the need for prompt multidisciplinary management, especially in diabetic or immunocompromised patients.
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