Aspergillus ochraceus: A Rare Cause of Paranasal Fungal Ball

Abstract

Infection of paranasal sinuses is not uncommon. Fungal ball of the paranasal sinuses is a non-invasive form of paranasal sinus infection that has been documented to be more frequently caused by Aspergillus fumigatus than by other Aspergillus species and typically affects immunocompetent individuals more than those who are immunocompromised. Here, we report the first case of Aspergillus ochraceus  (A. ochraceus) in an immunocompromised patient with post-trauma maxillary implant who presented with transient ischemic attack and incidental findings of fungal ball within the right maxillary sinus from the Computed Tomography (CT) scan.  A. ochraceus is a species under the Aspergillus section Circumdati, a widely distributed fungus which is pathogenic to humans that can lead to various clinical implications. A. ochraceus was detected from paranasal tissue sent for culture. The laboratory culture findings were further supported by histopathological evidence of fungal hyphae and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) identification.