Acute invasive rhinosinusitis case caused by Aspergillus flavus in two patients prediagnosed with mucormycosis

Acute invasive rhinosinusitis caused by Aspergillus spp. may lead to invasive disease and mortality, especially in immunocompromised individuals. In this report, two invasive fungal rhinosinusitis cases in an immune compromised patient have been presented that were pre-diagnosed with ucormycosis, but with a positive culture for Aspergillus flavus. Twenty-four years old male patient with aplastic anemia and seven years old patient with acute lymphoblastic leukemia; facial pain, edema, and necrotic lesions developed in both cases. Tissue samples were obtained from lesions through the nose by biopsy for definitive diagnosis. Septate fungal hyphae observed on the microscopic examination of the specimen, and A. flavus was isolated in the culture in both cases. Surgical debridement could not be performed because of patients’ general conditions. Despite antifungal therapy and treatments, patients died. Delay in diagnosis and treatment may lead to high mortality rates. These cases emphasize the importance of diagnosis with culture. J Microbiol Infect Dis 2015;5(3): 137-14