Unusual presentations of isolated sphenoid fungal sinusitis

Isolated sphenoid fungal sinusitis is a rare and often difficult to diagnos e condition as the presenting symptoms are often vague and non-specific. In this series each case has a different clinical presentation with a differe nt causative fungus. Although isolated fungal sphenoid sinusitis is usually seen in immunocompromised individuals, two of the three cases presented we re immunocompetent. The fungi were Pseudallescheria boydii, Aspergillus fum igatus and Schizophyllum commune. In order to illustrate the great diversit y of clinical signs, each case is individually presented. The characteristi c radiological signs and the clinical management of each case are also pres ented. The danger signs of associated pathology are discussed with particul ar reference to an associated squamous carcinoma in one case. Surgical opti ons and chemotherapy are discussed. Isolated sphenoid fungal sinusitis is a rare condition that if undiagnosed may result in considerable morbidity an d even mortality of patients.