Proptosis as the initial presentation of fungal sinusitis in immunocompetent patients.

Background: Fungal sinusitis typically occurs in immunocompromised patients. The authors report four cases of fungal sinusitis in immunocompetent young adults, all of whom had proptosis.
Methods: The diagnosis in all four patients was determined after orbital imaging and sinus biopsies.
Results: All four patients required surgical removal of the fungal source and anti-fungal chemotherapy postoperatively.
Conclusion: Patients with proptosis, ocular pain, or other symptoms suggestive of orbital cellulitis unresponsive to antibiotic treatment should undergo radiographic imaging. If sinus disease is present, biopsy and culture may lead to the diagnosis of fungal disease. Surgical debridement and the appropriate systemic antifungal therapy usually lead to cure.