Rhinosinusitis caused by Saksenaea erythrospora in an immunocompetent patient in India: a first report

Introduction: Saksenaea erythrospora is a recently described species that has been reported in two human cases of cutaneous infection. The present case is, to the best of our knowledge, the first with invasive infection of the sinuses by this fungus and the first report of its isolation from India. Case presentation: A 44-year-old woman was diagnosed with a pre-septal cellulitis and pansinusitis. She was non-diabetic and did not have any other co-morbidity. The patient underwent emergency endoscopic endonasal debridement for right pansinusitis with right orbital nerve decompression and left-sided functional endoscopic sinus surgery. A right orbital exenteration was performed to prevent further spread of the infection. Debrided material from the orbit grew S. erythrospora, the identity of which was confirmed by molecular techniques. The infection spread subcutaneously to the cheek and neck. The patient was treated with intravenous amphotericin B, to which she responded favourably. Conclusion: S. erythrospora can cause rhinosinusitis and appears to have a propensity for subcutaneous spread. The fungus is present in the environment in India. Treatment with amphotericin B was successful in our case.