A 35-year-old immunocompromised man presents with facial pain, nasal congestion, and black necrotic tissue in the nasal cavity. Non-contrast CT of the paranasal sinuses shows hyperdense material within the maxillary sinus with bony destruction. The most likely diagnosis is:
- A Invasive fungal sinusitis (mucormycosis) ✓
- B Acute bacterial sinusitis
- C Allergic fungal sinusitis
- D Wegener granulomatosis
Correct answer: A. Invasive fungal sinusitis (mucormycosis)
Explanation
Invasive fungal sinusitis (mucormycosis or aspergillosis) occurs in immunocompromised patients (diabetic ketoacidosis, neutropenia) and presents with black necrotic eschar, facial pain, and bony destruction on CT. Hyperdense material may be seen. Allergic fungal sinusitis causes hyperdense material but without bony destruction or necrosis. Bacterial sinusitis shows air-fluid levels without bony destruction.
Reference: Diagnostic Imaging: Head and Neck, 4th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.