(026) Allergic Fungal Rhinosinusitis: An Advanced Case with Intradural Extension

Introduction: Allergic fungal rhinosinusitis(AFRS) accounts for up to 10% of chronic rhinosinusitis cases. The mainstay of treatment consists of both surgery and medical management. When left untreated, AFRS can cause local bony remodeling and erosion. Here we present a case of advanced AFRS causing dural erosion.

Methods: Case report with review of the literature.

Results: A 26-year-old African American male with a history of diabetes mellitus presented to the hospital after experiencing new-onset seizures in the preceding two weeks. Imaging demonstrated pan-sinusitis with extensive dehiscence of the frontal sinus posterior table and sinus contents "replacing the frontal lobe parenchyma." The patient was taken to the OR with neurosurgery for functional endoscopic sinus surgery and cranialization. Intraoperatively, dural erosion was noted with fungal mucin and polyps directly communicating with the brain parenchyma. Additional details, including 10-month follow-up and photos to be included with the poster.

Conclusions: To our knowledge, we present the first case of AFRS with intradural extension. The unique presentation of seizures and cerebritis contributes to the existing literature on advanced AFRS.