PROPTOSIS AS THE INITIAL PRESENTATION OF FUNGAL SINUSITIS IN IMMUNOCOMPETENT PATIENTS

Background: Fungal sinusitis typically occurs in immunocompromised pat ients. The authors report four cases of fungal sinusitis in immunocomp etent young adults, all of whom had proptosis. Methods: The diagnosis in all four patients was determined after orbital imaging and sinus bi opsies. Results: All four patients required surgical removal of the fu ngal source and antifungal chemotherapy postoperatively. Conclusion: P atients with proptosis, ocular pain, or other symptoms suggestive of o rbital cellulitis unresponsive to antibiotic treatment should undergo radiographic imaging. If sinus disease is present, biopsy and culture may lead to the diagnosis of fungal disease. Surgical debridement and the appropriate systemic antifungal therapy usually lead to cure.