Fungal sinusitis secondary to Pseudallescheria boydii is rare, as only 25 cases have been previously reported in the literature. Although P boydii resembles Aspergillus on pathologic examination, it is typically resistant to amphotericin B. Therefore, culture is necessary to differentiate the two. Patients with P boydii sinusitis should generally be treated with a combination of surgery and antifungal therapy. Combination treatment is particularly important for immunocompromised patients with fungal invasion because mortality among these patients is high. The prognosis is better for immunocompetent patients, even those with fungal invasion. We describe a new case of invasive fungal sinusitis secondary to P boydii infection, and we review the literature on this emerging pathogen.
References
1.
RipponJW. Pseudallescheriasis. In: WonsiewiczM, ed. Medical Mycology: The Pathogenic Fungi and the Pathogenic Actinomycetes. 3rd ed. Philadelphia: W.B. Saunders; 1988:651–3.
2.
SiebenmannF.Die Schimmelmykosen des menschlichen Ohnes. Wiesbaden, Germany: Bergmann; 1889:95.
3.
ShearCL. Life history of an undescribed ascomycete isolated from a granular mycetoma of man. Mycologia1922;14:239–43.
4.
GreenWOJr., AdamsTE. Mycetoma in the United States; a review and report of seven additional cases. Am J Clin Pathol1964;42:75–91.
5.
TravisLB, RobertsGD, WilsonWR. Clinical significance of Pseudallescheria boydii: A review of 10 years’ experience. Mayo Clin Proc1985;60:531–7.
6.
GluckmanSJ, RiesK, AbrutynE.Allescheria (Petriellidium) boydii sinusitis in a compromised host. J Clin Microbiol1977;5:481–4.
7.
WinstonDJ, JordanMC, RhodesJ.Allescheria boydii infections in the immunosuppressed host. Am J Med1977;63:830–5.
8.
HechtR, MontgomerieJZ. Maxillary sinus infection with Allescheria boydii (Petriellidium boydii). Johns Hopkins Med J1978;142:107–9.
BryanCS, DiSalvoAF, KaufmanL, Petriellidium boydii infection of the sphenoid sinus. Am J Clin Pathol1980;74:846–51.
12.
BloomSM, WarnerRR, WeitzmanI.Maxillary sinusitis: Isolation of Scedosporium (Monosporium) apiospermum, anamorph of Petriellidium (Allescheria) boydii. Mt Sinai J Med1982;49:492–4.
13.
WinnRE, RamseyPD, McDonaldJC, DunlopKJ. Maxillary sinusitis from Pseudallescheria boydii. Efficacy of surgical therapy. Arch Otolaryngol1983;109:123–5.
14.
SchiessRJ, CosciaMF, McClellanGA. Petriellidium boydii pachymeningitis treated with miconazole and ketoconazole. Neurosurgery1984;14:220–4.
15.
MorganMA, WilsonWR, NeelHBIII. RobertsGD. Fungal sinusitis in healthy and immunocompromised individuals. Am J Clin Pathol1984;82:597–601.
16.
WashburnRG, KennedyDW, BegleyMG, Chronic fungal sinusitis in apparently normal hosts. Medicine (Baltimore)1988;67:231–47.
17.
SalitanML, LawsonW, SomPM, Pseudallescheria sinusitis with intracranial extension in a nonimmunocompromised host. Otolaryngol Head Neck Surg1990;102:745–50.
18.
TerrisDJ, SteinigerJR. Scedosporium apiospermum: Fungal sinusitis in an immunocompetent patient. Am J Rhinol1992;6:49–53.
19.
StammMA, FrableMA. Invasive sinusitis due to Pseudallescheria boydii in an immunocompetent host. South Med J1992;85:439–41.
20.
WattersGW, MilfordCA. Isolated sphenoid sinusitis due to Pseudallescheria boydii. J Laryngol Otol1993;107:344–6.
MeyerRD, GaultierCR, YamashitaJT, Fungal sinusitis in patients with AIDS: Report of 4 cases and review of the literature. Medicine (Baltimore)1994;73:69–78.
23.
FieroRA, GrothM, HurewitzA, Chronic hemoptysis: An unusual manifestation of fungal sinusitis. South Med J1995;88:782–5.
24.
MachadoCM, MartinsMA, Heins-VaccariEM, Scedosporium apiospermum sinusitis after bone marrow transplantation: Report of a case. Rev Inst Med Trop Sao Paulo1998;40:321–3.
25.
TadrosTS, WorkowskiKA, SiegelRJ, Pathology of hyalohyphomycosis caused by Scedosporium apiospermum (Pseudallescheria boydii): An emerging mycosis. Hum Pathol1998;29:1266–72.
26.
JonesJ, KatzSE, LubowM.Scedosporium apiospermum of the orbit. Arch Ophthalmol1999;117:272–3.
CastiglioniB, SuttonDA, RinaldiMG, Pseudallescheria boydii (Anamorph Scedosporium apiospermum). Infection in solid organ transplant recipients in a tertiary medical center and review of the literature. Medicine (Baltimore)2002;81:333–48.
30.
KatzensteinAL, SaleSR, GreenbergerPA. Allergic Aspergillus sinusitis: A newly recognized form of sinusitis. J Allergy Clin Immunol1983;72:89–93.
31.
deShazoRD, O'BrienM, ChapinK, A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg1997;123:1181–8.
32.
OliverioPJ, ZinreichSJ. Radiology of the nasal cavity and paranasal sinuses. In: CummingsCW, ed. Otolaryngology–Head and Neck Surgery. 3rd ed. St. Louis: Mosby; 1998:1082–3.
33.
AnaissieE, BodeyGP, KantarjianH, New spectrum of fungal infections in patients with cancer. Rev Infect Dis1989;11:369–78.
34.
WalshTJ, GrollAH. Emerging fungal pathogens: Evolving challenges to immunocompromised patients for the twenty-first century. Transpl Infect Dis1999;1:247–61.
35.
MallochD.New concepts in the Microascaceae illustrated by two new species. Mycologia1970;62:727–40.
36.
EmmonsCW. Allescheria boydii and Monosporium apiospermum. Mycologia1944;36:188–93.
37.
MohrJA, MuchmoreHG. Susceptibility of Allescheria boydii to amphotericin B. Antimicrobial Agents Chemother (Bethesda)1968;30:429–30.
38.
LutwickLI, GalgianiJN, JohnsonRH, StevensDA. Visceral fungal infections due to Petriellidium boydii (allescheria boydii). In vitro drug sensitivity studies. Am J Med1976;61:632–40.
39.
CosgroveRF, BeezerAE, MilesRJ. In vitro studies of amphotericin B in combination with the imidazole antifungal compounds clotrimazole and miconazole. J Infect Dis1978;138:681–5.
40.
WalshTJ, PeterJ, McGoughDA, Activities of amphotericin B and antifungal azoles alone and in combination against Pseudallescheria boydii. Antimicrob Agents Chemother1995;39:1361–4.
41.
RadfordSA, JohnsonEM, WarnockDW. In vitro studies of activity of voriconazole (UK-109,496), a new triazole antifungal agent, against emerging and less-common mold pathogens. Antimicrob Agents Chemother1997;41:841–3.
42.
McGinnisMR, PasarellL, SuttonDA, In vitro evaluation of voriconazole against some clinically important fungi. Antimicrob Agents Chemother1997;41:1832–4.
43.
Cuenca-EstrellaM, Ruiz-DiezB, Martinez-SuarezJV, Comparative in-vitro activity of voriconazole (UK-109,496) and six other antifungal agents against clinical isolates of Scedosporium prolificans and Scedosporium apiospermum. J Antimicrob Chemother1999;43:149–51.
