case_images: PMC10559376_01
case_images: Preoperative T1WI with contrast magnetic resonance imaging: (a) axial, (b) coronal, and (c) sagittal planes in which an isodense irregular lesion can be seen completely invading the sphenoid and ethmoid sinuses. Gadolinium enhancement shows ring enhancement. (d) T2WI sequence revealed a highly hypointense lesion, which is suggestive of an infectious etiology.
case_images: SNI-14-321-g001.jpg
case_images: PMC10559376_01_SNI-14-321-g001.jpg
case_images: F1
case_images: On T2WI, a highly hypointense appearance of the lesion suggests an infectious etiology [Figure 1].
case_images: Postoperative T1WI with contrast magnetic resonance imaging: (a) sagittal, (b) coronal, and (c) axial planes revealed gross total resection of the lesion.
case_images: SNI-14-321-g002.jpg
case_images: PMC10559376_01_SNI-14-321-g002.jpg
case_images: F2
case_images: Postoperative MRI showed complete resection of the lesion [Figure 2].
case_images: (a) Micromorphology of the filamentous fungus Drechslera hawaiiensis using lactophenol cotton blue stain. Hyaline fungi can acquire the blue hue from lactophenol, whereas dematiaceous fungi will exhibit a brown discoloration caused by the mold's pigment production. (b) Macroscopic sample of the thick, greasy, and dark material extracted from the antrum. There was an abundance of dark brown mucous which possessed a smooth and buttery texture, along with buttery consistency and grayish color.
case_images: SNI-14-321-g003.jpg
case_images: PMC10559376_01_SNI-14-321-g003.jpg
case_images: F3
case_images: The fungus was determined to be D. hawaiiensis, due to its morphological appearance [Figure 3].