A Case of Allergic Fungal Sinusitis due to Curvularia

Hae-Sun Chung; Jang Ho Lee; Hyo Yeol Kim; Nam Yong Lee

doi:10.5145/KJCM.2010.13.2.98

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Chung, Lee, Kim, and Lee: A Case of Allergic Fungal Sinusitis due to Curvularia

Original Article

Korean J Clin Microbiol 2010;13(2):98-101.

Published online: 21 June 2010

DOI: https://doi.org/10.5145/KJCM.2010.13.2.98

A Case of Allergic Fungal Sinusitis due to Curvularia

Hae-Sun Chung¹, Jang Ho Lee¹, Hyo Yeol Kim², Nam Yong Lee¹

¹Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

²Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: Nam Yong Lee, Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. (Tel) 82-2-3410-2706, (Fax) 82-2-3410-2719, (E-mail) mi-cro.lee@samsung.com

Received 18 November 2009 Revised 19 February 2010 Accepted 25 March 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Allergic fungal sinusitis (AFS) is a noninvasive form of fungal rhinosinusitis resulting from an IgE-mediated hypersensitivity reaction. The diagnosis of AFS can be established by demonstrating type I hypersensitivity, presence of fungus in mucus, eosinophilic mucin, nasal polyposis, and characteristic CT scans. Although AFS is not unusual and its incidence may be increasing, few cases have been reported in Korea. Here, we report the first case of typical AFS in which Curvularia species was isolated by culture.

Keywords: Allergic fungal sinusitis, Curvularia species

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Fig. 1.

Endoscopic finding of right nasal cavity shows polypoid mucosa and nasal septum deviation.

Fig. 2.

Coronal CT shows right nasal polyp with ipsilateral expansile sinusitis containing high attenuation material, which suggests allergic fungal sinusitis with associated polypoid mucocele.

Fig. 3.

Typical allergic mucin demonstrating Charcot-Leyden crystals and many eosinophils.

Fig. 4.

The colonies growing on Sabouraud's dextrose agar, 25°C, 5 days (A) front and (B) reverse. Curvularia species appear as shiny velvety-black, fluffy growth on the colony surface. Microscopic examinations of conidia (lactophenol cotton blue stain; ×400) (C) Curvularia species is distinguished by septate, dematiaceous hyphae producing brown, geniculate conidiophores.

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