INVASIVE SINONASAL DISEASE DUE TO SCOPULARIOPSIS-CANDIDA - CASE-REPORT AND REVIEW OF SCOPULARIOPSOSIS

Sinonasal infection with fungi of the order Mucorales-termed mucormyco sis or zygomycosis-is sometimes seen in immunosuppressed patients, inc luding those with diabetic ketoacidosis and malignancy. We describe a case of invasive sinonasal infection with Scopulariopsis candida (not among the Mucorales organisms) in a 12-year-old girl who was being tre ated for non-Hodgkin's lymphoma. Only a few cases of invasive infectio n with Scopulariopsis species have been reported previously; five of s ix of these cases were associated with persistent or fatal disease. Ou r patient survived without undergoing radical surgical debridement and was treated with granulocyte colony-stimulating factor, amphotericin B, and itraconazole; chemotherapy was stopped. In vitro susceptibility testing of our patient's Scopulariopsis isolate showed that it was re sistant to amphotericin B and that it was relatively susceptible to it raconazole and miconazole. The case described herein demonstrates the expanding spectrum of fungal organisms that may cause invasive sinonas al infection in immunocompromised hosts and the need for reliable anti fungal susceptibility testing.