Invasive rhinosinusitis due to Penicillium chrysogenum in an adolescent man with new-onset leukaemia: a diagnostic dilemma

Sejal Bhavsar, Alina Sheikh, Fumiko Dekio, Asif Noor

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

An adolescent boy with newly diagnosed T-cell acute lymphoblastic leukaemia developed right eye and facial pain, and a 1 cm × 2 cm area of black eschar over his hard palate. Initial differential diagnosis included rhinocerebral mucormycosis and aspergillosis, and he was started on liposomal amphotericin B. Later, he underwent nine surgical debridements of his sinus cavities, resection of a third of his palate and right orbital exenteration. While histological specimens exhibited features of both Aspergillus and Mucor, a PCR assay detected Penicillium chrysogenum. He was successfully treated with amphotericin B and Posaconazole. P. chrysogenum has been reported in a rare case of endocarditis, a case of post-traumatic endophthalmitis, disseminated infection in a child with Henoch-Schonlein syndrome, and one fatal adult case of invasive rhinosinusitis. While infection from Penicillium species is rare, it should be considered as a cause of invasive rhinosinusitis in cases of unclear histopathology.

Original languageEnglish
Article numbere252265
JournalBMJ Case Reports
Volume15
Issue number12
DOIs
StatePublished - 9 Dec 2022

Keywords

  • Infectious diseases
  • Otolaryngology / ENT
  • Paediatric oncology

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