# A Rare Case of Fungal Granuloma Confined to the Nasal Septum

## TL;DR

A rare case of a fungal granuloma was found only in the nasal septum, highlighting the need to consider such infections in nasal abnormalities.

## Contribution

This is the first reported case of a fungal granuloma confined exclusively to the nasal septum.

## Key findings

- A granulomatous lesion with bone destruction was identified in the nasal septum through postoperative pathology.
- The case expands the differential diagnosis for nasal septum abnormalities to include fungal granulomas.
- Fungal granulomas are rare and previously unreported as confined solely to the nasal septum.

## Abstract

Granulomatous lesions in the nasal sinuses are associated with a variety of diseases, including immune disorders such as sarcoidosis, vasculitis, immunoglobulin G4 (IgG4)-related diseases, malignant lymphomas, and microbial infections. Here, we report a rare case of fungal granuloma that occurred exclusively within the nasal septum.

The patient presented to the Department of Surgery with the chief complaint of nasal obstruction associated with nasal septal deviation. A bulge was found below the right nasal septum. Initially, it was diagnosed as mucosal swelling associated with rhinitis, and surgery was performed. A granulomatous lesion with bone destruction was found under the mucosa of the nasal septum, which led to the diagnosis of fungal granulation based on postoperative pathology. Though bacterial and fungal infections of the nasal septum are occasionally observed, this is the first reported instance of a fungal granuloma confined to the nasal septum. Infection within the nasal septum, although rare, should also be considered as a differential diagnosis for morphological abnormalities of the nasal septum.