{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:14:52Z","timestamp":1789182892979,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Anterior nasal septum abscess is not a rare clinical disease entity. In terms of the etiologies of the disease, bacteria are obviously more common than fungi. Fungal culture and pathological examination are essential for diagnosis of a fungal abscess of the anterior nasal septum and the basis of prescription of antifungal agents. We report a 57-year-old male patient who came to our outpatient clinic due to refractory nasal congestion for 3 weeks despite receiving treatments by a local medical doctor. Radical surgery with postoperative adjuvant radiotherapy for the right buccal cancer was carried out 14 years ago. The patient has diabetes mellitus and the blood sugar level has been well controlled by oral hypoglycemic agents over the past several years. Computed tomography revealed an abscess in the anterior septum along with rhinosinusitis. Incision and drainage of the nasal septum abscess and functional endoscopic sinus surgery were carried out. Fungal culture and pathological examination confirmed a fungal abscess in the anterior nasal septum and fungal ball rhinosinusitis. Antibiotics and an antifungal agent were given, and the postoperative course was uneventful. A dialectical argument was made regarding the causal relationship between the fungal abscess of the anterior nasal septum and maxillary fungal ball sinusitis. A literature review of the previous case reports was carried out to elucidate the immune status of patients of this disease. In order to reach a rapid establishment of a fungal abscess of the anterior nasal septum, clinicians should keep this disease in mind and remain vigilant. An immuno-compromised status is more commonly found in patients with fungal abscess of the anterior nasal septum and is another important characteristic of this disease. Prompt diagnosis and effective treatment are equally important in patients with lower immune status of this kind, and the latter is based on the former.<\/jats:p>","DOI":"10.3390\/jof10070497","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T16:51:12Z","timestamp":1721321472000},"page":"497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fungal Abscess of Anterior Nasal Septum Complicating Maxillary Sinus Fungal Ball Rhinosinusitis Caused by Aspergillus flavus: Case Report and Review of Literature"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-7912","authenticated-orcid":false,"given":"Shih-Wei","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Ming","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung 204, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Chien","family":"Cheng","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Department of Pathology, Chang Gung Memorial Hospital, Keelung 204, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kishimoto, I., Shinohara, S., Ueda, T., Tani, S., Yoshimura, H., and Imai, Y. (2017). Orbital apex syndrome secondary to a fungal nasal septal abscess caused by Scedosporium apiospermum in a patient with uncontrolled diabetes: A case report. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2753-6"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.2500\/ar.2015.6.0139","article-title":"Fungal septal abscess complicating maxillary sinus fungus balls in an immunocompetent host","volume":"6","author":"Patel","year":"2015","journal-title":"Allergy Rhinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"234","DOI":"10.11604\/pamj.2020.36.234.23186","article-title":"Fungal nasal septum abscess caused by Aspergillus flavus complicating sinonasal surgery","volume":"36","author":"Rochdi","year":"2020","journal-title":"Pan Afr. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.otohns.2006.07.022","article-title":"Fungal nasal septal abscess in the immunocompromised patient","volume":"136","author":"Walker","year":"2007","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1128\/JCM.43.4.1998-2001.2004","article-title":"Fusarium verticillioides abscess of the nasal septum in an immunosuppressed child: Case report and identification of the morphologically atypical fungal strain","volume":"43","author":"Dornbusch","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3342\/kjorl-hns.2017.17657","article-title":"Invasive Aspergillosis Associated Bacterial Infection in the Nasal Septum after Sphenoid Sinus Surgery","volume":"61","author":"Sohn","year":"2018","journal-title":"Korean J. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"378","DOI":"10.3342\/kjorl-hns.2012.55.6.378","article-title":"A Case of Nasal Septal Abscess Caused by Combined Bacterial and Fungal Infection in the Immunocompromised Patient","volume":"55","author":"Cho","year":"2012","journal-title":"Korean J. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1097\/INF.0b013e31820b7c3a","article-title":"Isolated nasal septum necrosis caused by Aspergillus flavus in an immunocompromised child","volume":"30","author":"Naeem","year":"2011","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1056\/NEJM199707243370412","article-title":"Destruction of the nasal septum by Aspergillus infection after autologous bone marrow transplantation","volume":"337","author":"Siberry","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1878","DOI":"10.3174\/ajnr.A0708","article-title":"Nasal septal abscess in patients with immunosuppression","volume":"28","author":"Debnam","year":"2007","journal-title":"Am. J. Neuroradiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e01444-18","DOI":"10.1128\/MRA.01444-18","article-title":"Draft Genome Sequence of Azole-Resistant Aspergillus thermomutatus (Neosartorya pseudofischeri) Strain HMR-AF-39, Isolated from a Human Nasal Septum Abscess Aspirate","volume":"8","author":"Dufresne","year":"2019","journal-title":"Microbiol. Resour. Announc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Izoton, C.F.G., de Brito Sousa, A.X., Valete, C.M., Schubach, A.O., Proc\u00f3pio-Azevedo, A.C., Zancop\u00e9-Oliveira, R.M., de Macedo, P.M., Gutierrez-Galhardo, M.C., Castro-Alves, J., and Almeida-Paes, R. (2023). Sporotrichosis in the nasal mucosa: A single-center retrospective study of 37 cases from 1998 to 2020. PLoS Negl. Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011212"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Escalante, L., Granizo-Rubio, J., Pinos-Leon, V., Tello, S., Maldonado, A., and Cherrez-Ojeda, I. (2022). Nasal cartilage destruction associated to cutaneous histoplasmosis in AIDS. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07351-0"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.bjorl.2020.10.002","article-title":"Nasal septal abscess: Uncommon localization of extraintestinal amoebiasis","volume":"87","author":"Yavuz","year":"2021","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1111\/j.1442-9071.2004.00877.x","article-title":"Orbital apex syndrome secondary to Pseudallescheria boydii fungal sinusitis in an immunocompetent patient","volume":"32","author":"Thiagalingam","year":"2004","journal-title":"Clin. Exp. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s00405-018-5258-z","article-title":"Clinical pattern of fungal balls in the paranasal sinuses: Our experience with 70 patients","volume":"276","author":"Seo","year":"2019","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"269","DOI":"10.4193\/Rhin11.223","article-title":"Sinus fungal balls: Characteristics and management in patients with host factors for invasive infection","volume":"50","author":"Toussain","year":"2012","journal-title":"Rhinology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.amjoto.2019.06.006","article-title":"Fungus ball of the maxillary sinus: Retrospective study of 48 patients and review of the literature","volume":"40","author":"Costa","year":"2019","journal-title":"Am. J. Otolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1258\/002221502760132665","article-title":"Nasal septal abscess: An unusual complication of acute spheno-ethmoiditis","volume":"116","author":"Pang","year":"2002","journal-title":"J. Laryngol. Otol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"180","DOI":"10.3325\/cmj.2013.54.180","article-title":"Arterial blood architecture of the maxillary sinus in dentate specimens","volume":"54","author":"Kqiku","year":"2013","journal-title":"Croat. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.otohns.2005.09.005","article-title":"An anatomical study of the arteries of the anterior nasal septum","volume":"134","author":"Chiu","year":"2006","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/00006534-199504001-00004","article-title":"Nasal tip blood supply: An anatomic study validating the safety of the transcolumellar incision in rhinoplasty","volume":"95","author":"Rohrich","year":"1995","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1288\/00005537-198104000-00010","article-title":"Management of nasal septal abscess","volume":"91","author":"Ambrus","year":"1981","journal-title":"Laryngoscope"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1001\/archotol.1982.00790540052015","article-title":"Nasal septal abscess of dental origin","volume":"108","author":"Helman","year":"1982","journal-title":"Arch. Otolaryngol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1017\/S0022215111002404","article-title":"Structural characteristics of septal cartilage and mucoperichondrium","volume":"126","author":"Aksoy","year":"2012","journal-title":"J. Laryngol. Otol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s12663-018-01182-w","article-title":"Fungal Rhinosinusitis: Unravelling the Disease Spectrum","volume":"18","author":"Singh","year":"2019","journal-title":"J. Maxillofac. Oral. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0377-1237(03)80022-9","article-title":"Allergic Fungal Sinusitis with Mycetoma","volume":"59","author":"Das","year":"2003","journal-title":"Med. J. Armed Forces India"},{"key":"ref_28","unstructured":"Anaissie, E.J., McGinnis, M.R., and Pfaller, M.A. (2009). CHAPTER 11\u2014Aspergillus. Clinical Mycology, Churchill Livingstone. [2nd ed.]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/S0030-6665(20)30472-2","article-title":"Irradiated soft tissue and its management","volume":"28","author":"Hom","year":"1995","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_30","first-page":"30","article-title":"Radiation-Induced Wound Infections in Operated Soft Tissue Sarcomas: An Unbelievable Challenge in a Series of Five Cases","volume":"10","author":"Wagh","year":"2019","journal-title":"J. Orthop. Case Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1002\/1097-0142(19920601)69:11<2736::AID-CNCR2820691118>3.0.CO;2-S","article-title":"Preoperative combined chemotherapy and radiation therapy plus radical surgery in advanced head and neck cancer. Five-year results with impressive complete response rates and high survival","volume":"69","author":"Slotman","year":"1992","journal-title":"Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.pedneo.2012.04.011","article-title":"Nasal septal abscess in an immunocompetent child","volume":"53","author":"Huang","year":"2012","journal-title":"Pediatr. Neonatol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sabino, R., and Wiederhold, N. (2022). Diagnosis from Tissue: Histology and Identification. J. Fungi, 8.","DOI":"10.3390\/jof8050505"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S261","DOI":"10.1080\/13693780802247702","article-title":"Differences in pathogenicity and clinical syndromes due to Aspergillus fumigatus and Aspergillus flavus","volume":"47","author":"Pasqualotto","year":"2009","journal-title":"Med. Mycol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1056\/NEJMra2027424","article-title":"Aspergillus Infections","volume":"385","author":"Thompson","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1080\/00275514.2019.1631137","article-title":"Diversity of thermophilic and thermotolerant fungi in corn grain","volume":"111","author":"Sandona","year":"2019","journal-title":"Mycologia"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"778","DOI":"10.4315\/0362-028X-40.11.778","article-title":"Differences Between Aspergillus flavus Strains in Growth and Aflatoxin B(1) Production in Relation to Water Activity and Temperature","volume":"40","author":"Northolt","year":"1977","journal-title":"J. Food Prot."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Zhou, Z.X., Yin, X.D., Zhang, Y., Shao, Q.H., Mao, X.Y., Hu, W.J., Shen, Y.L., Zhao, B., and Li, Z.L. (2022). Antifungal Drugs and Drug-Induced Liver Injury: A Real-World Study Leveraging the FDA Adverse Event Reporting System Database. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.891336"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jmii.2014.06.009","article-title":"A systematic review and meta-analysis of diagnostic accuracy of serum 1,3-\u03b2-D-glucan for invasive fungal infection: Focus on cutoff levels","volume":"48","author":"He","year":"2015","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"3783","DOI":"10.1128\/JCM.00879-11","article-title":"Beta-D-glucan detection as a diagnostic test for invasive aspergillosis in immunocompromised critically ill patients with symptoms of respiratory infection: An autopsy-based study","volume":"49","author":"Lagrou","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Ferreras-Antolin, L., Borman, A., Diederichs, A., Warris, A., and Lehrnbecher, T. (2022). Serum Beta-D-Glucan in the Diagnosis of Invasive Fungal Disease in Neonates, Children and Adolescents: A Critical Analysis of Current Data. J. Fungi, 8.","DOI":"10.3390\/jof8121262"}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/10\/7\/497\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:19:15Z","timestamp":1760109555000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/10\/7\/497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,18]]},"references-count":41,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["jof10070497"],"URL":"https:\/\/doi.org\/10.3390\/jof10070497","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,18]]}}}