Acute invasive fungal sinusitis with orbital cellulitis from Cambodian tertiary hospital: a case report

Objective We intend to study treatments outcomes of a patient undergoing functional endoscopic sinus surgery diagnosed with an invasive fungal sinusitis and showed biggest management challenges. Methods a case report of a patients who had come to emergency department in late stage with complication to orbital cellulitis resulted with an abscess of cerebral frontal due to late diagnosis and poor access to public health service at poor resources setting like Cambodia. In this study, a delay around three days for making the diagnosis and required an aggressive medical or surgical intervention to prevent life threatening result. Result the patient survived around three months post endoscopic sinus surgery and hemi-maxillectomy. The condition of patient undermined by immunocompromising factors of diabetes and cardiopathy resulted in pneumonia and pleurisy. The patient undergoing three surgeries including eye exenteration, surgical debridement of sinus, incision & draining of cerebral abscess, however, blood glucose was not stable, with hyperglycemia and amphotericin B injection led to renal failure despite urgent medical and surgical intervention with multi-disciplinary team. Future study on how to properly manage this grave disease is needed to provide a better safe and care for future patients. In sum, the invasive fungal sinusitis is a life-threatening sinus disease that left patient with lethal complication despite prompt medical or surgical intervention.