Nasal cavity, paranasal sinuses, nasopharynx

Infectious lesions

Invasive fungal sinusitis

Topic Completed: 1 November 2004

Minor changes: 6 October 2020

Copyright: 2004-2021,, Inc.

PubMed Search: Invasive fungal sinusitis nasal

Nat Pernick, M.D.
Page views in 2020: 2,782
Page views in 2021 to date: 6,910
Cite this page: Pernick N. Invasive fungal sinusitis. website. Accessed December 3rd, 2021.
Definition / general
  • Relatively common life threatening fungal infection, associated with diabetic ketoacidosis, poor glycemic control or immunosuppression
  • Spreads rapidly across nerves and tissue planes to blood vessels of orbit and brain, causes thrombosis, hemorrhage and infarction
  • Member of phylum Zygomycota, class Zygomycetes, order Mucorales; found in high organic matter and soil
  • Mortality rate of 48%
Case reports
Microscopic (histologic) description
  • Broad nonseptate hyphae branching at 90 degrees, accompanied by numerous neutrophils and histiocytes within granulation tissue
Microscopic (histologic) images

Contributed by Kelly Magliocca, D.D.S., M.P.H. (Case of the Month #493)

Tissue necrosis

Necrotic and
adjacent viable
sinonasal mucosa

Ossified cartilage
and adjacent viable
sinonasal mucosa

Angiovasion, 20x

Angiovasion, 40x

Grocott's methenamine silver stain

Board review style question #1
Which of the following anatomic sites is most commonly involved in acute invasive fungal sinusitis?

  1. Nasal septum
  2. Inferior turbinate
  3. Ethmoid sinus
  4. Middle turbinate
Board review style answer #1
D. The middle turbinate is most commonly involved among the anatomic sites listed.

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Reference: Invasive fungal sinusitis
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