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Topic:Fungal

Fungal infections in horses encompass a variety of conditions caused by different fungal species that can affect the skin, respiratory system, and other body systems. These infections can range from superficial skin infections, such as ringworm, to more serious systemic infections like aspergillosis. The presence of fungi in the equine environment and their interactions with the horse's immune system can influence the development and severity of these infections. Diagnosis often involves identifying the specific fungal organism through laboratory testing, while treatment may include antifungal medications and supportive care. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, diagnosis, and treatment of fungal infections in horses.
First Case Report of Aspergillary Rhinopharyngitis in a Foal From Chile.
Journal of equine veterinary science    December 4, 2021   Volume 109 103831 doi: 10.1016/j.jevs.2021.103831
Thomson P, Toro J, Lara F, Hernández D, Aros K, Valenzuela-Lopez N.We present the first case of rhinopharyngitis due to Aspergillus fumigatus in a purebred Chilean horse. Clinically, manifested mucopurulent discharge from both nostrils, inflammation of the nasal, ocular, and ear mucosa; associated with decay and hyporexia. Based on the clinical signs and analysis of the mycological and molecular transtracheal aspirate sample, the present case was diagnosed as Aspergillus fumigatus rhinopharyngitis. After the antifungal susceptibility test, oral itraconazole treatment was maintained for 45 days, showing no clinical sign.
The Effect of Topical Oxygen Therapy in Horses Affected with Mycosis of the Guttural Pouch: An Experimental Pilot Study and a Case Series.
Animals : an open access journal from MDPI    November 22, 2021   Volume 11, Issue 11 doi: 10.3390/ani11113329
Lepage OM, Di Francesco P, Moulin N, Gangl M, Texier G, Marchi J, Cadoré JL.Background: The management of bleeding originating from the guttural pouch (GP) has a high success rate, but the resolution of the macroscopic inflammatory lesions in the case of mycosis (GPM) is highly variable; the resolution of neurological disorders is inconstant and challenging. Objectives: Our aim was to test the feasibility and safety of topical oxygen therapy (TOT) in horses after induction of GPM and in cases with naturally occurring disease. Study design: This study was an in vivo experimental and retrospective two-phase study. Methods: During phase 1, the pilot study, both GPs were ...
Nasopharyngeal bacterial and fungal microbiota in normal horses and horses with nasopharyngeal cicatrix syndrome.
Journal of veterinary internal medicine    November 16, 2021   Volume 35, Issue 6 2897-2911 doi: 10.1111/jvim.16307
Rodríguez N, Whitfield-Cargile CM, Chamoun-Emanuelli AM, Hildreth E, Jordan W, Coleman MC.The nasopharyngeal bacterial and fungal microbiota of normal horses and those with nasopharyngeal cicatrix syndrome (NCS) are unknown. Objective: To describe the microbiota from nasopharyngeal washes of healthy horses and of horses acutely affected with NCS. Methods: Twenty-six horses acutely affected with NCS horses and 14 unaffected horses. Methods: Prospective, observational cohort study. Horses were recruited by investigators through personal communications in central Texas. Bacterial (16s RNA) and fungal (internal transcribed spacer) microbiota from nasopharyngeal washes were evaluated. P...
Re-discovery of Trichophyton bullosum in North Africa as a cause of severe dermatophytosis in donkeys.
Folia microbiologica    November 10, 2021   Volume 67, Issue 2 265-275 doi: 10.1007/s12223-021-00930-9
Peano A, Arnoldi S, Čmoková A, Hubka V.This article reports the first verified cases of infection by Trichophyton bullosum in Africa since the description of the fungus, isolated in 1933 from the coat of horses in Tunisia and Mali. We found the fungus in cutaneous samples obtained from donkeys suffering from severe dermatitis with areas of alopecia and scaling in the surroundings of Cairo (Egypt). Fungal elements (arthroconidia and hyphae) were seen at the microscopy of material collected by skin scraping and digested in NaOH. Fungal colonies grown on various culture media were identified through PCR and sequencing of the ITS rDNA ...
Equine grass sickness (a multiple systems neuropathy) is associated with alterations in the gastrointestinal mycobiome.
Animal microbiome    October 9, 2021   Volume 3, Issue 1 70 doi: 10.1186/s42523-021-00131-2
McGorum BC, Chen Z, Glendinning L, Gweon HS, Hunt L, Ivens A, Keen JA, Pirie RS, Taylor J, Wilkinson T, McLachlan G.Equine grass sickness (EGS) is a multiple systems neuropathy of grazing horses of unknown aetiology. An apparently identical disease occurs in cats, dogs, rabbits, hares, sheep, alpacas and llamas. Many of the risk factors for EGS are consistent with it being a pasture mycotoxicosis. To identify potential causal fungi, the gastrointestinal mycobiota of EGS horses were evaluated using targeted amplicon sequencing, and compared with those of two control groups. Samples were collected post mortem from up to 5 sites in the gastrointestinal tracts of EGS horses (EGS group; 150 samples from 54 horse...
Fungal osteitis of the axial aspect of the mid body of the medial proximal sesamoid bone in a horse.
The Canadian veterinary journal = La revue veterinaire canadienne    August 4, 2021   Volume 62, Issue 8 867-871 
Merchán A, Voss JK, Dubois MS.The satisfactory outcome of fungal osteitis in an 8-year-old American Quarter Horse is described. The horse was admitted with a grade 4 out of 5 lameness and exhibited metacarpophalangeal synovial effusion, indicative of a mild suppurative inflammation. Results of initial radiographic and ultrasonographic examination were unremarkable. Intra-articular anesthesia of the metacarpophalangeal joint allowed localization of the insult. It was not until day 6 of hospitalization when lytic changes on the axial aspect were observed on radiographic examination. Arthroscopic examination permitted identif...
Antifungal susceptibility of dermatophytes from racehorses in Japan.
Veterinary dermatology    June 29, 2021   Volume 32, Issue 5 474-e129 doi: 10.1111/vde.12993
Watanabe R, Huruta H, Ueno Y, Nukada T, Niwa H, Shinyashiki N, Kano R.Luliconazole (LCZ) is an imidazole antifungal medication that exhibits excellent activity against dermatophytes. As a topical cream and lotion (approved for human use), LCZ has demonstrated a broad spectrum of activity against human dermatophytoses. Objective: This is the first study to investigate the in vitro susceptibility of clinical isolates from horse dermatophytoses to LCZ. Methods: No animals were used in this study. Methods: In the present study, the in vitro susceptibilities of clinical isolates of dermatophytes to LCZ, clotrimazole (CTZ), miconazole (MCZ) and terbinafine (TRF) wer...
Antimicrobial peptides in domestic animals and their applications in veterinary medicine.
Peptides    May 24, 2021   Volume 142 170576 doi: 10.1016/j.peptides.2021.170576
Valdez-Miramontes CE, De Haro-Acosta J, Aréchiga-Flores CF, Verdiguel-Fernández L, Rivas-Santiago B.Antimicrobial peptides (AMPs) are molecules with a broad-spectrum activity against bacteria, fungi, protozoa, and viruses. These peptides are widely distributed in insects, amphibians and mammals. Indeed, they are key molecules of the innate immune system with remarkable antimicrobial and immunomodulatory activity. Besides, these peptides have also shown regulatory activity for gut microbiota and have been considered inductors of growth performance. The current review describes the updated findings of antimicrobial peptides in domestic animals, such as bovines, goats, sheep, pigs, horses, cani...
The clinical and histopathologic effects of potentiated chlorhexidine in the upper respiratory tract of horses.
Veterinary surgery : VS    May 11, 2021   Volume 50, Issue 6 1209-1217 doi: 10.1111/vsu.13649
Stewart HL, Engiles JB, Richardson DW, Levine DG.To describe the bactericidal and fungicidal properties of a 0.0005% chlorhexidine (CHD) solution potentiated with EDTA-Tris buffers (CHD-EDTA-Tris) and evaluate the safety of 0.0005% CHD-EDTA-Tris in the upper respiratory tract (URT) of normal horses. Methods: Clinical, prospective study. Methods: Eight healthy, skeletally mature horses. Methods: In vitro-serial dilutions of CHD-EDTA-Tris and EDTA-Tris alone were evaluated for bactericidal and fungicidal activity against Aspergillus fumigatus, Escherichia coli, Staphylococcus aureus, Streptococcus equi subspecies ssp. equi, Streptococcus equi ...
Impact of Yeast Endometritis on Fertility in the Mare.
Journal of equine veterinary science    February 11, 2021   Volume 99 103409 doi: 10.1016/j.jevs.2021.103409
Nielsen JM, Fog P, Bojesen AM.The breeding prognosis for a mare with fungal (yeast or mold) endometritis is generally considered poor. To our knowledge, however, no reports have been published on the expected pregnancy rate for mares diagnosed with a fungal infection. Insemination records from 3,223 mares inseminated at two stud farms were retrospectively examined. Mares diagnosed with fungal endometritis were all treated with uterine lavage using physiological saline, intrauterine deposition of 100 mg Clotrimazole vagitorial tablets and oxytocin (10 i.e., i.m.) for three consecutive days. From mares with signs of endometr...
Evaluation of the ocular surface mycobiota in clinically normal horses.
PloS one    February 4, 2021   Volume 16, Issue 2 e0246537 doi: 10.1371/journal.pone.0246537
Walsh ML, Meason-Smith C, Arnold C, Suchodolski JS, Scott EM.The eye is host to myriad bacterial, fungal, and viral organisms that likely influence ocular surface physiology in normal and diseased states. The ocular surface mycobiota of horses has not yet been described using NGS techniques. This study aimed to characterize the ocular surface fungal microbiota (mycobiota) in healthy horses in 2 environmental conditions (stalled versus pasture). Conjunctival swabs of both eyes were obtained from 7 adult stallions stabled in an open-air pavilion and 5 adult mares living on pasture. Genomic DNA was extracted from ocular surface swabs and sequenced using pr...
Biological methods for the control of gastrointestinal nematodes.
Veterinary journal (London, England : 1997)    December 22, 2020   Volume 268 105602 doi: 10.1016/j.tvjl.2020.105602
Szewc M, De Waal T, Zintl A.Gastrointestinal nematodes (GIN) are a cause of significant losses in animal production worldwide. In recent years, there have been important advances in the biological control of GIN of ruminants and horses. While these measures are still relatively under-utilised in practice, interest will undoubtedly grow due to the emergence of drug resistant parasite populations, the rise in demand for organically farmed products (which does not allow prophylactic use of drugs, including anthelmintics) and legislation, which regulates and restricts the use of anthelmintics. This review provides an overvie...
Differentiation of S. chartarum (Ehrenb.) S. Hughes Chemotypes A and S via FT-IR Spectroscopy.
Mycopathologia    October 10, 2020   Volume 185, Issue 6 993-1004 doi: 10.1007/s11046-020-00495-0
Ekruth J, Gottschalk C, Ulrich S, Gareis M, Schwaiger K.Stachybotrys (S.) chartarum is a cellulolytic mould with the ability to produce highly cytotoxic macrocyclic trichothecenes. Two chemotypes are defined according to their ability to produce either atranones or satratoxins. S. chartarum has been well known as the causative agent of the lethal disease stachybotryotoxicosis in horses. Further investigations revealed that this disease is strictly correlated with the presence of macrocyclic trichothecenes. Furthermore, their occurrence in water-damaged buildings has been linked to adverse health effects such as the sick building syndrome. As the ch...
Epidemiological and Molecular Investigation of Ocular Fungal Infection in Equine from Egypt.
Veterinary sciences    September 8, 2020   Volume 7, Issue 3 130 doi: 10.3390/vetsci7030130
Tahoun A, Elnafarawy HK, Elmahallawy EK, Abdelhady A, Rizk AM, El-Sharkawy H, Youssef MA, El-Khodery S, Ibrahim HMM.Diagnosis and treatment of ocular fungal infection in equine seems very challenging for owners and clinicians. The present study aimed to identify and characterize fungal species isolated from the eyes of clinically healthy and diseased equines (N = 100) from Dakahlia Governorate, Egypt. The work also involved morphological and molecular characterization of the major fungal species. In addition, correlations between the occurrence of isolated fungi and some of the potential risk factors were also investigated. Interestingly, the prevalence rate of ocular mycosis in all examined equines in the ...
Clinical Feasibility and Airway Deposition of Nebulized Voriconazole in Healthy Horses.
Journal of equine veterinary science    September 3, 2020   Volume 94 103246 doi: 10.1016/j.jevs.2020.103246
Sierra-Rodriguez T, Groover ES, Lascola KM, Mora-Pereira M, Lee YH, Duran SH, Ravis WR, Spangler E, Hathcock T, Wooldridge AA.Voriconazole (VRC) is a potential treatment for pneumomycosis in horses. The objectives of this study were to determine if the delivery of Vfend using a Flexineb nebulizer produced clinically significant [VRC] in lower airways. The hypothesis was that [VRC] after delivery by nebulization would be greater in the pulmonary epithelial lining fluid than plasma. A secondary objective was to determine [VRC] in upper airways through the collection of nasopharyngeal wash (NPW) samples. Voriconazole solution [Vfend-6.25 mg/mL, 100 (n = 2), 200 (n = 3), 500 (n = 1) mg] was nebulized once in 6 health...
Equine endometritis: a review of challenges and new approaches.
Reproduction (Cambridge, England)    August 18, 2020   Volume 160, Issue 5 R95-R110 doi: 10.1530/REP-19-0478
H A Morris L, M McCue P, Aurich C.Endometritis in the mare begins as a normal physiological inflammatory response to breeding that involves both a mechanical and immunological response pathway activated to rid the uterus of semen and bacteria. With successful resolution of this inflammation, the mare's uterus will provide a hospitable environment for the development of the semi-allogenic conceptus. If the mare fails to resolve this inflammatory response within 48 h of breeding, she will become susceptible to persistent breeding-induced endometritis (PBIE) which will have detrimental effects on her fertility. This condition can...
Rare Generalized Form of Fungal Dermatitis in a Horse: Case Report.
Animals : an open access journal from MDPI    May 17, 2020   Volume 10, Issue 5 871 doi: 10.3390/ani10050871
Padalino B, Sandy JR, Barrasso R, Trotta A, Bozzo G, Cafarchia C.A rare case of spp. dermatitis in a horse is presented. After unrelated, previous surgery and antibiotic treatment, a saddle horse showed well-circumscribed areas of non-pruritic alopecia. Suspecting allergic skin disease, the horse was treated with corticosteroids. The skin lesion spread, and a second veterinarian was consulted. At clinical examination, the horse was lethargic, pyretic and hair was shedding/easily epilated over the head, neck, shoulders, and legs and the hind legs were swollen. Blood analysis revealed mild leucocytosis and hyperglobulinemia. Hair, skin scraping, and skin bio...
In vitro susceptibility of Aspergillus and Fusarium associated with equine keratitis to new antifungal drugs.
Veterinary ophthalmology    May 16, 2020   Volume 23, Issue 5 918-922 doi: 10.1111/vop.12774
Roberts D, Cotter HVT, Cubeta M, Gilger BC.To determine minimum inhibitory concentrations (MICs) of four fungal species isolated from horses presented with equine fungal keratitis (EFK) in the southeastern United States to previously untested azole, echinocandin, and carboxamide antifungal drugs. Methods: In vitro assays were performed to determine the susceptibility of Aspergillus flavus, A. fumigatus, Fusarium falciforme, and F. keratoplasticum to five antifungal drugs representing three modes of action. Results: Luliconazole exhibited increased growth inhibition against both Aspergillus and Fusarium compared to commonly used, stan...
Utility of systemic voriconazole in equine keratomycosis based on pharmacokinetic-pharmacodynamic analysis of tear fluid following oral administration.
Veterinary ophthalmology    May 8, 2020   Volume 23, Issue 4 640-647 doi: 10.1111/vop.12764
Tamura N, Okano A, Kuroda T, Niwa H, Kusano K, Matsuda Y, Fukuda K, Mita H, Nagata S.To clarify the detailed pharmacokinetics (PK) of orally administered voriconazole in tear fluid (TF) of horses for evaluating the efficacy of voriconazole secreted into TF against equine keratomycosis. Methods: Five healthy Thoroughbred horses. Methods: Voriconazole was administrated through a nasogastric tube to each horse at a single dose of 4.0 mg/kg. TF and blood samples were collected before and periodically throughout the 24 hours after administration. Voriconazole concentrations in plasma and TF samples were analyzed using liquid chromatography-electrospray tandem-mass spectrometry. T...
In vitro synergy of eugenol on the antifungal effects of voriconazole against Candida tropicalis and Candida krusei strains isolated from the genital tract of mares.
Equine veterinary journal    April 30, 2020   Volume 53, Issue 1 94-101 doi: 10.1111/evj.13268
Sharifzadeh A, Shokri H.Due to the limited range of antifungals available to treat genital Candida infections and the emergence of resistant isolates, attention has focused on the antifungal potency of natural compounds with promising biological properties. Objective: To examine whether eugenol synergises the in vitro efficacy of voriconazole against Candida strains isolated from the genital tract of mares. Methods: In vitro experiment. Methods: The antifungal activity of eugenol and voriconazole was evaluated using the broth microdilution assay (CLSI- M27-A3). Synergism of eugenol and voriconazole against genital Ca...
Sustained-release voriconazole-thermogel for subconjunctival injection in horses: ocular toxicity and in-vivo studies.
BMC veterinary research    April 16, 2020   Volume 16, Issue 1 115 doi: 10.1186/s12917-020-02331-5
Mora-Pereira M, Abarca EM, Duran S, Ravis W, McMullen RJ, Fischer BM, Lee YP, Wooldridge AA.Keratomycosis is a relatively common, sight threatening condition in horses, where treatment is often prolonged and costly. Subconjunctival (SCo) injections offer less resistance to drug diffusion than the topical route, resulting in better penetration to the ocular anterior segment. Voriconazole, a second generation triazole antifungal, is effective against common fungal organisms causing keratomycosis. If combined with a thermogel biomaterial, voriconazole can be easily injected in the SCo space to provide sustained drug release. The purpose of this study was to evaluate the drug concentrati...
Guttural pouch mycosis, sympathy for Aspergillus nidulans.
Revista iberoamericana de micologia    March 3, 2020   Volume 37, Issue 3-4 75-76 doi: 10.1016/j.riam.2020.01.002
Cabañes FJ.No abstract available
Rhinosinusitis in an Australian mare caused by Flavodon flavus, a recently recognized invasive fungal pathogen of the horse. Suen WW, Zedler S, Price R, Maguire T, Halliday C, Rosenblatt AJ, Allavena RE, Owen H, Medina-Torres CE.We describe herein the clinical, endoscopic, computed tomography (CT), pathologic, and microbiologic features of an infection caused by an under-recognized fungal pathogen, , in a 25-y-old Australian Quarter Horse. The horse had a unilateral obstructive nasal mass, resulting in stertor and dyspnea. On endoscopy, the mass was tan, multinodular, and completely obstructed the nasal passage. CT analysis revealed a large, soft tissue-attenuating and partially mineralized mass in the right nasal passage and dorsal-conchofrontal sinus, expanding into adjacent paranasal sinuses with associated bone ly...
Effects of nebulized dexamethasone on the respiratory microbiota and mycobiota and relative equine herpesvirus-1, 2, 4, 5 in an equine model of asthma.
Journal of veterinary internal medicine    December 3, 2019   Volume 34, Issue 1 307-321 doi: 10.1111/jvim.15671
Bond SL, Workentine M, Hundt J, Gilkerson JR, Léguillette R.Prolonged exposure to environmental antigens or allergens elicits an immune response in both healthy horses and those with mild asthma. Corticosteroids often are used to treat lower airway inflammation. Objective: To investigate the changes in equine herpesvirus (EHV)-1,2,4,5 glycoprotein B gene expression and changes in respiratory bacterial and fungal communities after nebulized dexamethasone treatment of horses with asthma. Methods: Horses with naturally occurring mild asthma (n = 16) and healthy control horses (n = 4). Methods: Prospective, randomized, controlled, blinded clinical trial. P...
Fungal and chemical diversity in hay and wrapped haylage for equine feed.
Mycotoxin research    November 27, 2019   Volume 36, Issue 2 159-172 doi: 10.1007/s12550-019-00377-5
Andersen B, Phippen C, Frisvad JC, Emery S, Eustace RA.The presence of fungi and mycotoxins in silage (fermented maize) for cattle and other ruminants have been studied extensively compared to wrapped haylage (fermented grass) for horses and other monogastric animals. The purpose of this work was to examine the fungal diversity of wrapped haylage and conventional hay and to analyse the forage sample for fungal metabolites. Faeces samples were also analysed to study the fate of fungi and metabolites. Fungal diversity of the samples was determined by direct plating on DG18, V8 and MEA and chemical analyses were done using LC-MS/MS. The results show ...
Retrospective Analysis of Aetiological Agents Associated with Pulmonary Mycosis Secondary to Enteric Salmonellosis in Six Horses by Panfungal Polymerase Chain Reaction.
Journal of comparative pathology    November 26, 2019   Volume 174 1-7 doi: 10.1016/j.jcpa.2019.10.002
Hensel M, Meason-Smith C, Plumlee QD, Myers AN, Coleman MC, Lawhon S, Rodrigues Hoffmann A, Rech RR.Pulmonary mycosis secondary to enterocolitis is an uncommon diagnosis in equine medicine, but is thought to result from mucosal compromise and translocation of enteric fungi. The aetiological agent associated with translocation is often identified based on fungal culture or hyphal features in histological sections. In order to understand better the aetiological agents involved, six horses diagnosed with Salmonella enteritis and concurrent pulmonary mycosis were identified retrospectively through a database search of veterinary teaching hospital records. Samples from these cases were subjected ...
The gut microbiome of horses: current research on equine enteral microbiota and future perspectives.
Animal microbiome    November 13, 2019   Volume 1, Issue 1 14 doi: 10.1186/s42523-019-0013-3
Kauter A, Epping L, Semmler T, Antao EM, Kannapin D, Stoeckle SD, Gehlen H, Lübke-Becker A, Günther S, Wieler LH, Walther B.Understanding the complex interactions of microbial communities including bacteria, archaea, parasites, viruses and fungi of the gastrointestinal tract (GIT) associated with states of either health or disease is still an expanding research field in both, human and veterinary medicine. GIT disorders and their consequences are among the most important diseases of domesticated Equidae, but current gaps of knowledge hinder adequate progress with respect to disease prevention and microbiome-based interventions. Current literature on enteral microbiomes mirrors a vast data and knowledge imbalance, w...
Fungal Placentitis Caused by Aspergillus terreus in a Mare: Case Report.
Journal of equine veterinary science    October 15, 2019   Volume 83 102799 doi: 10.1016/j.jevs.2019.102799
Orellana-Guerrero D, Renaudin C, Edwards L, Rose E, Aleman M, Moore PF, Dujovne G.Placentitis has been reported as the most important cause of equine abortions, stillbirths, and perinatal deaths in horses. Most cases are caused by bacteria and less commonly by fungal elements. The aim of this report is to describe the clinical presentation of a fungal placentitis caused by Aspergillus terrerus. A 5-year-old thoroughbred maiden mare at the 217th day of gestation presented with some classic signs of placentitis (premature udder development and milk dripping). All ultrasonographic findings were consistent with a live fetus and a severe placentitis. On vaginal examination, pur...
Culture-independent and dependent evaluation of the equine paranasal sinus microbiota in health and disease.
Equine veterinary journal    October 10, 2019   Volume 52, Issue 3 455-463 doi: 10.1111/evj.13168
Beste KJ, Lawhon SD, Chamoun-Emanuelli AM, Duff AH, Coleman MC, Griffin CE, Hardy J, Whitfield-Cargile CM.Horses with bacterial sinusitis frequently undergo empirical treatment with antimicrobials, however, in some cases bacterial culture of the affected sinus is used to direct therapy. Data regarding which organisms are part of the commensal microbiota of the equine sinus are lacking making it difficult to interpret culture results and guide empiric antimicrobial selection. Objective: Our objectives were to describe the bacterial and fungal microbiota of the paranasal sinuses in clinically normal horses using culture-dependent and independent approaches and to compare the bacterial culture and su...
Phaeohyphomycotic Rhinitis Caused by Bipolaris hawaiiensis in a Horse.
Journal of equine veterinary science    October 1, 2019   Volume 82 102798 doi: 10.1016/j.jevs.2019.102798
Legere RM, Wooldridge AA, Sandey M, Hanson RR, Cole R.This case represents the first reported case of Bipolaris hawaiiensis infection in an equid, and its aggressive clinical course. This case provides important descriptive and prognostic information for horses diagnosed with phaeohyphomycotic rhinitis. A 19-year-old American Quarter Horse mare was presented for second opinion of stertor and exercise intolerance of four-month duration. Endoscopy revealed generalized, proximal nasal edema, and computed tomography identified a soft tissue mass eroded through the rostral nasal bone. Biopsy of the mass was identified as a fungal granuloma caused by B...