# Invasive Sphenoid Sinus Aspergillosis in a Patient With Chronic Neutropenia: A Case Report

## TL;DR

A 75-year-old woman with chronic neutropenia developed invasive sphenoid sinus aspergillosis and was successfully treated with antifungal therapy.

## Contribution

Highlights the occurrence of invasive fungal sinusitis in patients with transient or borderline immunosuppression.

## Key findings

- Invasive sphenoid sinus aspergillosis can occur in patients with chronic neutropenia.
- Successful treatment with liposomal amphotericin B followed by oral voriconazole led to full recovery.
- Fungal sinusitis should be considered in patients without classical immunosuppression.

## Abstract

Invasive sinus aspergillosis is an uncommon but potentially life-threatening infection typically observed in immunocompromised individuals. However, increasing reports highlight its occurrence in patients with transient or borderline immunosuppression. We present a case of a 75-year-old female with treated mantle cell lymphoma and chronic neutropenia who developed invasive sphenoid sinus aspergillosis. Diagnosis was confirmed via imaging and histopathology following surgical intervention. She was treated with liposomal amphotericin B, followed by a successful transition to oral voriconazole, with full clinical recovery. This case underscores the importance of considering fungal sinusitis in patients without classical or sustained immunosuppression and supports a multidisciplinary, stepwise approach to management.