Figure 4.

An 11-year-old male, who presented with rhinorrhea and a 2-month history of “left eye swelling,” is diagnosed with allergic fungal sinusitis (Curvularia Sp). (a) Noncontrast computed tomography of the head in axial view shows opacification of the left ethmoid and sphenoid sinuses, with internal hyperattenuating material and expansion and remodeling of the involved sinuses (asterisk). (b) T2-weighted and (c) T1-weighted magnetic resonance imaging of the face in axial view demonstrates the low signal intensity of the mucin due to high concentrations of various metals metabolized by the fungus and a high protein and low free water content. (d) Corresponding T1-weighted postgadolinium magnetic resonance imaging of the face in axial view demonstrates a hyperintense inflamed mucosal lining. No enhancement of the sinus cavity or its contents allows a differentiation from neoplastic entities.