A RARE CASE OF RHINITIS CASEOSA AND FUNGAL SINUSITIS

Rhinitis caseosa  also  called  as  nasal  cholesteastoma  is  a  misnomer. The essential criteria for diagnosing rhinitis caseosa  are  -1) nasal  polyp  and  offensive  purulent  discharge  and  cheesy material ;  2)  clinical  or  radiological  evidence  of  bony  expansion  of  the  sinus  walls  and  3) demonstration  of  heterogenous  opacification  of  the   paranasal  sinuses  with  areas  of  hyper-attenuation. Fungal sinusitis is a  distinct  clinical  entity  characterized  by  inflammation  of  the  sinus mucosa  caused  by  fungal  infection  like  aspergillus,  mucormycosis,  candida, scedosporium, pencillium. We hereby present a case of  68  years  old  male  presented  to  OPD  with  left  sided  nasal obstruction, nasal  discharge  and  anosmia, for  4 months. Patient was evaluated and underwent Microdebrider  assisted  polypectomy  with  FESS.  Early recognition and prompt initiation of combined medical treatment and surgical intervention done to prevent Its aggressive nature  and propensity  for  orbital  and  intracranial  extension.