Invasive fungal infections of face – A diagnostic challenge: Case series and review

Cutaneous mycoses are common in immune compromised individuals but in immune competent individuals these become a diagnostic challenge due to the rarity of the incidence and dubious clinical picture. We present three cases of cutaneous mycoses in immune competent adults.Case 1: 62 year old immune competent male presented with right sided cheek swelling with induration. Malignancy was considered and a biopsy was done which showed entomophthoromycosis.Case 2: 77 year old immune competent male presented with hard indurated swelling in the dorsum of nose. Radiology showed heterogeneous soft tissue density in the cheek. Fungal culture confirmed presence of Conidiobolus coronata.Case 3: A 60 year old female presented with right cheek swelling which was 5 * 3 cm and showed heterogeneous soft tissue density in the subcutaneous tissue with no nasal lesion. Fine needle aspirations and culture confirmed presence of Aspergillus fumigatus.First two cases responded completely to Itraconazole and potassium iodide therapy and only Itraconazole was given in the third case. Surgery could be avoided in these cases.