Maxillary sinusitis caused by Ascotricha chartarum Berk. (anamorph Dicyma ampullifera Boul.): a new phaeoid opportunistic human pathogen.

The first human infection caused by Ascotricha chartarum of the maxillary sinus is described. The patient, a 35-year-old woman, developed a hard bony swelling on the right cheek. Her maxillary X-ray showed complete opacity of the right maxillary antrum with a shadow of erosion. C.T. scan revealed a radio opaque mass having vacuolated appearance in the antrum. The debris removed from the antrum contained phaeoid fungal elements. At places, softening of the bone was observed. The mucoperiosteum exhibited acute inflammatory reaction and invasion by the pathogen. The pale brown to subhyaline fungal elements in biopsy tissue grew Ascotricha chartarum, a phaeoid ascomycetous fungus in culture. The patient had a smooth recovery when treated with betadine lavage and itraconazole after surgical intervention.