# An Atypical Case of Chronic Fungal Rhinosinusitis: Temporary Symptom Relief Resulted in a Delay of Diagnosis and Brain Abscess

## TL;DR

A diabetic man's fungal sinus infection was delayed due to temporary symptom relief, leading to severe complications like brain abscess.

## Contribution

Highlights how transient symptom remission can mask chronic fungal rhinosinusitis progression, stressing the need for early diagnosis.

## Key findings

- Mild and remitting symptoms delayed diagnosis of invasive fungal rhinosinusitis.
- Spontaneous resolution of symptoms led to 11 months without treatment, resulting in brain abscess.
- Emergency surgery and antifungal therapy could not prevent vision loss.

## Abstract

A 67-year-old diabetic man with chronic invasive fungal rhinosinusitis (IFRS) experienced mild, remitting visual symptoms, delaying diagnosis. Despite early MRI evidence of orbital apex inflammation, spontaneous symptom resolution led to discontinuation of hospital visit. Eleven months later, he developed orbital apex syndrome and intracranial complications. Emergency surgery and antifungal therapy were initiated, but vision loss persisted. This case underscores the risk of transient symptom remission masking IFRS progression, emphasizing the importance of early intervention.