Sphenoidal fungal sinusitis with middle cranial fossa extension

Case History:

45 years old female patient was admitted with

C/O:

1. Altered consciousness - 2 days duration

History elicited:

1. Headache intense more in the occipital area - 2 months

2.Low grade fever - 20 days (for which the patient received intermittent treatment)

3. Patient had vomiting - 3days back

Patient is a known diabetic on regular treatment with oral hypoglycemics

Imaging:

CT scan para nasal sinuses plain coronal cut showing fungal mass inside sphenoid sinus with erosion of its supero lateral wall

MRI PNS showing fungal mass inside sphenoid sinus. Cavernous sinus is free

MRI lateral view showing fungal mass inside sphenoid sinus

Management:

Debridement was done endoscopically under general anesthesia. Patient had complete recovery following surgery.

Fungal mass inside sphenoid sinus seen endoscopically