MYCOLab Ai Logo - gold and army green

Mixed Infection With Aspergillosis and Actinomycosis in the Maxillary Sinus: A Case Report

Summary

A 74-year-old woman with diabetes and rheumatoid arthritis developed a rare dual infection in her maxillary sinus (a cavity above the teeth) caused by both a fungus (Aspergillus) and bacteria (Actinomyces). Imaging tests initially suggested only fungal infection, but surgery and tissue examination revealed both organisms were present. The patient was successfully treated with surgical removal of the infected material combined with antibiotics, leading to complete recovery.

Background

Fungal sinus infections caused by Aspergillus (fungus balls) are relatively common, while actinomycosis sinusitis is rare. Mixed infections with both aspergillosis and actinomycosis are extremely rare with limited previous reports on imaging findings and clinical characteristics.

Objective

To report a rare case of simultaneous aspergillosis and actinomycosis occurring in the maxillary sinus and perform a literature review to improve understanding of this condition’s diagnosis and management.

Results

Histopathological examination confirmed both Aspergillus hyphae and actinomycete masses with Splendore-Hoeppli phenomenon. The patient was treated with surgical resection followed by intravenous penicillin and oral amoxicillin, resulting in clinical improvement and complete resolution at 8-month follow-up.

Conclusion

Mixed infection with aspergillosis and actinomycosis is extremely rare. In cases with overlapping risk factors such as immunosuppression and dental procedures, clinicians should consider the possibility of mixed infection and rely on histopathological examination to guide appropriate treatment combining surgical resection with prolonged antibiotic therapy.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 41063880, DOI: 10.7759/cureus.91758
Scroll to Top