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A Case of Sphenoid Sinusitis With Epidural Abscess due to Fungal Infection and Mixed Infection With Eikenella corrodens and Aggregatibacter segnis

Summary

A 60-year-old woman developed a severe headache caused by a fungal and bacterial infection in her sphenoid sinus (located deep in the skull). The infection spread intracranially, creating an abscess. Doctors used imaging scans to diagnose the problem, performed surgery to drain the infection and remove the fungal material, and treated the patient with antibiotics. The patient recovered completely with no recurrence after four years.

Background

Rhinosinusitis is a rare intracranial complication that can become serious if diagnosis and treatment are delayed. Although the incidence has decreased with antimicrobial agents, intracranial complications from sinusitis remain clinically significant with mortality rates of 0-7% and residual disease in 10-25% of survivors.

Objective

To report a case of sphenoiditis with epidural abscess caused by a mixed fungal and bacterial infection with Eikenella corrodens and Aggregatibacter segnis, along with clinical course and literature review.

Results

Pathological examination revealed Aspergillus in the sphenoid sinus with epidural abscess in the right middle cranial fossa. Blood cultures showed E. corrodens and A. segnis. Following endoscopic sinus surgery and antibiotic treatment with meropenem, the patient was discharged symptom-free after 20 days with no recurrence at 4-year follow-up.

Conclusion

This case represents the first reported instance of sphenoid sinus mycosis combined with epidural abscess from mixed bacterial infection. Early recognition of intracranial spread through imaging and prompt combined surgical and antibiotic intervention is essential for favorable outcomes.
  • Published in:Case Reports in Otolaryngology,
  • Study Type:Case Report,
  • Source: PMID: 40862105, DOI: 10.1155/crot/7328742
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