Frontal sinus destruction from allergic eosinophilic fungal rhinosinusitis.

Extensive fungal infections of the paranasal sinuses are most often associated with immunocompromised patients or poorly controlled diabetics. Seldom do young, otherwise healthy patients present with advanced disease destroying bone and compressing the dura and frontal lobe posteriorly. A case of eosinophilic fungal rhinosinusitis which grew Curvularia lunata in culture is reported. Bone destruction can be common as an expanding inflammatory mass pushes and weakens surrounding bone. The destruction of the frontal sinus with the compression of the dura into the anterior cranial fossa of a 26-year-old requires drainage, reconstruction, and medical management. Our experience with the disease and our approach is reviewed.