a 21 years old male with severe proptosis,preseptal swelling




Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Mohadese Mahvari


Case Section



Patient's Information

Gender : Male
Age : 21


Clinical Summary

a 21 years old male with severe proptosis,preseptal swelling and cellulitis and known case of AML


Imaging Findings

There is necrosed mucosa in the ethmoid ,sphenoid and frontal sinuses, which is typically seen in acute invasive fungal sinusitis; progression of the fungal infection via cribriform plate to frontal lobes with ring enhancement of the lesions after contrast injection is noticeble. Post constrast sequences show non enhancing angioinvasive fungal infection in the mucosa that gives the Black turbinate sign. Acute hydrocephalus associated with periventricular leackage is seen. Within the brain, areas of diffusion restriction are in keeping with acute infarcts in the cerebellar hemispheres, This case demonstrates the MRI appearances of acute invasive fungal sinusitis, together with one of its dreaded complications: septic infarction


Differential Diagnosis



Final Diagnosis

Acute invasive fungal sinusitis


Discussion (Related Text)

Neutropenia during consolidation chemotherapy for acute myeloid leukaemia. Has right preseptal painful swelling and severe proptosis and cellulitis exending to the nose with right-sided reduction in visual acuity and hemianopia



Safder S, Carpenter JS, Roberts TD et-al. The "Black Turbinate" sign: An early MR imaging finding of nasal mucormycosis. AJNR Am J Neuroradiol. 2010;31 (4): 771-4. AJNR Am J Neuroradiol (full text) - doi:10.3174/ajnr.A1808 - Pubmed citation


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