Primary cryptococcosis of paranasal sinus in immunocompetent patient: two case reports and review of literature

Chronic invasive granulomatous fungal sinusitis (CIGFS) caused by cryptococcus is extremely rare, especially in immunocompetent patients. We report two cases of CIGFS caused by cryptococcus in immunocompetent patients. Case 1 was infected in the left ethmoid sinus with orbital invaded later. Case 2 was infected in the left maxillary sinus and sphenoid sinus with Intracranial invaded later. The two cases all underwent two surgical operations, and postoperative pathology showed granulomatous inflammation. The third postoperative pathology confirmed cryptococcal infection by PAS and AB-PAS stain. Case 1 was underwent orbital exenteration debridement and appropriate antifungal therapy after surgery, and was followed up for 18 months without recurrence. Case 2 had no chance of surgery at last and went to a higher level hospital for continue therapy and then losted follow-up. Early recognition of cryptococcal sinusitis and appropriate surgery with administration of appropriate antifungal therapy has a great impact on the good prognosis.