Alternaria Sinusitis

Abstract

Alternaria is a fungus of the class Deuteromycetes and the family Dematiaceae. Fungi of this genus have generally been regarded as nonpathogenic and as contaminants when isolated from clinical specimens. Hypersensitivity to Alternaria spores, however, has long been recognized as a cause of allergic pulmonary disease. More recently, the organism has also been demonstrated to have potential for opportunistic invasion of immunosuppressed and debilitated patients. Presented is a case in which this organism was repeatedly isolated from naso-oral tissue specimens from an otherwise healthy patient. The organism was seen in biopsies from a granulomatous hyperplastic destructive disease of the maxilla and soft tissues of the face which extended to the ethmoid sinus and fistulized through the hard palate. The clinical course, pathophysiology and therapeutic approach are discussed. The management of this disease requires a multidisciplinary approach involving the otolaryngologist, infectious disease specialist and pathologist.