Role of mycology in accurate diagnosis of various fungal aetiologies in rhino/orbital diseases: ‘needle in a haystack’

Contrast-enhanced CT (CECT) of the nose and paranasal sinuses showed left lobulated hyper dense non enhancing lesion with extensive destruction involving the orbit, maxillary, bilateral sphenoid and ethmoid sinuses and extending into intracranial and left infratemporal fossa with encasement of bilateral cavernous part of Internal Carotid Artery (ICA) (figure 2A,B). CECT, contrast-enhanced CT. Because of its extensive involvement in the skin and subcutaneous tissues, phaeohypomycosis was considered the diagnosis. Fungal culture Aside from the fact that fungal culture helps in identifying the species of Aspergillus infection, it also helps in identifying the resistance to antifungal therapy; for example, Aspergillus terreus and Aspergillus nidulans are found to have an inherent resistance to amphotericin-b.1–3 All medically important fungi samples must be sent in a sealed, leak-proof, sterile container marked with a biohazard sticker to comply with occupational safety and health administration safety standards.4 It should be transported within 2 hours; otherwise, it should be stored at 4℃.