, Volume 183, Issue 2, pp 439–443 | Cite as

A Case of Fungus Ball-Type Maxillary Sinusitis Due to Penicillium Roqueforti

  • T. Radulesco
  • A. Varoquaux
  • S. Ranque
  • P. Dessi
  • J. Michel
  • C. Cassagne
Original Paper


The Penicillium genera, encompassing about 225 different species of fungi, are naturally present in the environment. These genera are poorly linked to human disease, except for Penicillium marneffei causing septicemia in immunocompromised hosts. Thus, Penicillium species recovered from respiratory tract samples are often considered as inhaled contaminants in the clinical laboratory. However, we report here a case of fungal maxillary sinusitis due to Penicillium roqueforti diagnosed in a 40-year-old female, a teacher, complaining of moderate pain for months in the maxillary sinus and chronic posterior rhinorrhea. CT scanner and MRI enabled a preliminary diagnosis of left maxillary fungus ball-type sinusitis with calcified material seen on CT and marked very low signal in T2 weighted images seen on MRI. Anatomopathological and mycological examination of sinusal content showed septate hyphae. Direct sequencing of the sinusal content revealed P. roqueforti. P. roqueforti has been traditionally used in France for more than 200 years for cheese ripening. However, to our knowledge, this ascomycetous fungus has very rarely been associated in the literature with human disease. P. roqueforti is associated only with cheese worker’s lung, a hypersensitivity pneumonitis affecting employees in blue cheese factories. Other species in the Penicillium genus are reported to cause various disorders such as invasive infection, superficial infection or allergic diseases. P. roqueforti has never previously been reported as a cause of human infection. Thus, we report the first case of fungus ball due to P. roqueforti in an immunocompetent patient.


Penicillium roqueforti Sinusitis Maxillary sinus Fungus ball 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Assistance Publique, Hôpitaux de MarseilleLa Conception University HospitalMarseille CedexFrance
  2. 2.Aix-Marseille UniversityMarseille CedexFrance
  3. 3.Department of Radiology, Assistance Publique, Hôpitaux de Marseille, La ConceptionUniversity HospitalMarseille CedexFrance
  4. 4.CNRS, IRD, INSERM, AP-HM, URMITE, IHU Méditerranée-InfectionAix-Marseille UniversityMarseilleFrance

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