Sinus aspergillosis in a hemodialysis patient

Unlike mucormycosis, which often is discussed in the nephrology literature, sinus aspergillosis is rarely reported. This phenomenon would appear to indicate that mucormycosis is more common than aspergillosis in dialysis patients. A review of the literature, however, demonstrates the contrary. We report a case of sinus aspergillosis in a middle-aged woman on chronic hemodialysis for 12 years. The initial presentation was chronic bacterial sinusitis, and thus sinus aspergilloma escaped our attention, suspected only after the discovery of a mass-like lesion over the left middle turbinate; the diagnosis was confirmed by imaging studies and pathological examination of the involved tissue. As aspergillosis of paranasal sinuses may present as chronic bacterial sinusitis, nephrologists and other dialysis staff must be aware of this possibility in order to facilitate early diagnosis and intervention.