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

Summary

A 74-year-old woman had a purulent nasal discharge for 1.5 years caused by two different infections occurring simultaneously in her maxillary sinus: aspergillosis (a fungal infection) and actinomycosis (a bacterial infection). Imaging initially suggested only a fungal ball, but pathological examination revealed both organisms were present. The patient was successfully treated with surgical removal of the infected material followed by antibiotic therapy.

Background

Fungal sinus infections, particularly fungus balls caused by Aspergillus, are relatively common, while actinomycosis of the paranasal sinuses 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 in the maxillary sinus and review the literature regarding mixed infections of these two conditions.

Results

Imaging findings suggested fungal ball infection. Histopathological examination confirmed both Aspergillus hyphae and actinomycete colonies with the Splendore-Hoeppli phenomenon. The patient was treated with surgical resection followed by intravenous penicillin and oral amoxicillin with favorable clinical outcome.

Conclusion

Mixed infection with aspergillosis and actinomycosis can occur and should be considered when overlapping risk factors are present. Histopathological examination is essential for accurate diagnosis, and treatment must address both conditions with appropriate antibiotics for actinomycosis in addition to surgical resection.
  • Published in:Cureus,
  • Study Type:Case Report,
  • Source: PMID: 41063880, DOI: 10.7759/cureus.91758
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