Bipolaris: A Serious New Fungal Pathogen of the Paranasal Sinus

Fungal infections of the paranasal sinuses are a welJ known cause of serious and often fatal disease. The usual fungal pathogens are the Phycomycetes (Mucor, Rhizopus) and Aspergillus species. Bipolaris species are a common soil fungus usually found in tropical and subtropical climates. This fungus rarely causes human infection. Only eight cases with primary involvement of the paranasal sinuses have been reported in the English literature at the time of this article. We are reporting two additional cases, with a case report of one of them. The purpose of this article is twofold: (I) we would like to bring to the attention of the practicing otolaryngologist a fungal infection that is an extremely unusual pathogen and is occurring in immunocompromised and immunocompetent individuals. This pathogen appears to be extremely difficult to eradicate once it has been contracted, whether the patient is immunocompetent or not.' We would like to clear up some apparent confusion in the literature about the correct name of this particular fungus. The literature is reviewed and pathology of this disease will be discussed, with recommendations for therapy.