Successful treatment of invasive fungal rhinosinusitis caused by Cunninghamella: A case report and review of the literature

Figure 1 Nasal endoscopy, computed tomography, and magnetic resonance imaging images. A: Endoscopic sinus surgery showed that the middle turbinate turned to be necrotic and fragile; B: The orbital fat appeared dark yellow, losing its bright color; C: Magnetic resonance imaging T2-weighted coronal image; D: Axial computed tomography scan with soft tissue window revealed inflammatory changes in the orbital fat, right ocular proptosis, thickening of extraocular muscles, and the distorted eyeball.

Figure 2 Culture results. A: Macroscopic appearance of C. bertholletiae; B: Microscopic morphology showing sporangiophore and sporangiola of C. bertholletiae. Lactophenol cotton blue staining. C. bertholletiae: Cunninghamella bertholletiae.

Figure 3 Histological findings. Histopathologic examination showed a large quantity of fungus mycelia and spores (gomori methenamine silver staining, × 200).