First report of chronic invasive fungal rhinosinusitis in a patient with ovarian cancer caused by Didymella pedeiae and successful treatment with voriconazole: A case report

Omid Raiesi; Seyed Jamal   Hashemi; Muhammad  Ibrahim Getso; Pegah  Ardi; Mojtaba   Mohammadi Ardehali; Vahid Raissi; Sina  Shamsaei; Zeinab   Borjian Boroujeni

doi:10.18502/cmm.7.1.6244

Omid Raiesi Department of Medical Parasitology and Mycology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Seyed Jamal Hashemi Department of Medical Parasitology and Mycology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Muhammad Ibrahim Getso Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, PMB 3011, Kano, Nigeria
Pegah Ardi Department of Medical Parasitology and Mycology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mojtaba Mohammadi Ardehali Department of Otorhinolaryngology, Faculty of Medicine, Tehran University of Medical Sciences, Amiralam Hospital, Tehran, Iran
Vahid Raissi Department of Medical Parasitology and Mycology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Sina Shamsaei Department of Medical Parasitology and Mycology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
Zeinab Borjian Boroujeni Department of Medical Parasitology and Mycology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/cmm.7.1.6244

Keywords: Chronic invasive fungal rhinosinusitis, Didymella pedeiae, Iran, Phoma species, Voriconazole

Abstract

Background and Purpose: Didymella pedeiae is a dematiaceous fungus that belongs to the Coelomycetes class. While species within this class are known to cause human infection, D. pedeiae had previously only been known as phytopathogens and had never been isolated from a human sample.

Case report: A 51-year-old Iranian female patient with ovarian cancer was admitted with unilateral lesions in paranasal sinuses and a five-month history of nasal obstruction,headache, postnasal drainage, swelling on the left side of the face, and orbital pain.Paranasal sinus computerized tomography scan revealed a soft tissue mass that filled the left nasal cavity, ethmoid, sphenoid, and frontal sinuses with more involvement in the maxillary and ethmoid sinuses. Antifungal treatment was simultaneously initiated with itraconazole+prednisolone 15 mg/day, and levofloxacin. Due to poor clinical response,IV voriconazole and amphotericin B were added to the treatment as well. The patient recovered completely after 10 weeks of therapy.

Conclusion: Here, we report the first case of human D. pedeiae infection in a patient
with ovarian cancer.