A 56-year-old male patient, resident in Olmué (Region of Valparaiso), with a history of chronic allergic rinitis since youth and fungal rhinosinusitis diagnosed and treated with oral fluconazole endoscopically.
She presented with a clinical picture of nasal and sword discharge, abundant yellowish color and bad odor, with posterior discharge, headache and decreased smell.
A computed axial tomography (CAT) of the sinuses showed thickening of the right frontal mucosa and thickening of the maxillary sinus mucosa and ipsilateral frontal sinus mucosa.
Surgery was performed that included eradication of endonasal lesions, wide right ethmectomy and middle meatus with Caldwell-Luc approach to the right maxillary sinus was sent to ensure endoscopic removal of abundant material.
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Bacterial cultures were all negative.
Direct microscopic examination with 20% KOH and Gomori-G staining revealed abundant hyphae septate at a 45° dichotomic angle.
Sabouraud agar cultures showed Curvularia sp.
The patient was treated with itraconazole 400 mg capsules a day for six months and inhaled corticosteroids.
Pathological response was good.
He is currently asymptomatic and performing all his usual activities.
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Identification of the species
Mucin samples were cultured in Sabouraud agar at 27 and 37°C, obtaining philamentous dark grey colonies with dry conidia in all cultures.
5 days after the onset of symptoms.
Afterwards, they were placed in corn flour agar and water agar with wheat straw at 25°C for 10 days.
Macroscopy: the colonies were of a tertile-shaped appearance with a cotton center, dark gray on the opposite side and black on the reverse, with abundant dry conidia.
Microscopy showed dematia hi, coni-diiophores more or less, central conidia more central conidia longer than the other cells, with 3 x these cells measuring 28 μm and 45 μm.
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The above description coincides with the species Curvularia inaequalis (Shear) Boedijn8,9.
