Eosinophilic fungal rhinosinusitis due to the unusual pathogen Curvularia inaequalis

Abstract

Among fungi, Curvularia inaequalis is a rare pathogen. We report the first case of non-invasive fungal rhinosinusitis caused by this species. Endoscopic sinus surgery revealed massive polyposis and the presence of viscous eosinophilic mucus that allowed the growth of the fungus. We diagnosed eosinophilic fungal rhinosinusitis based on the histological findings of fungal hyphae in association with degranulating eosinophils in the sinus mucus. After polypectomy and clearance of the affected sinuses, oral itraconazole was administered to prevent the recurrence. Given the ever-increasing list of opportunistic fungi that cause human infection, the case reported here provides further evidence that proper identification of the infective agents remains crucial for the patient's management. © 2009 Blackwell Publishing Ltd.