Fungal Sinusitis Masquerading as Trigeminal Neuralgia in an Immunocompetent Patient: A Case Report

Previous cases of trigeminal neuralgia (TN) caused by fungal sinusitis have been reported, but mainly in immunocompromised patients. We present a case of fungal sinusitis masquerading as trigeminal neuralgia in an immunocompetent patient and discuss the potential implications of these two diseases. The patient is a 59-year-old male who presented with a four-year duration of left facial pain. He had been diagnosed and treated for trigeminal neuralgia by a pain specialist but was subsequently referred to ENT after a MRI of the brain showed left maxillary sinusitis. Nasoendoscopy findings and a CT scan of the paranasal sinuses were concordant with left maxillary sinusitis. The patient underwent left functional endoscopic sinus surgery and recovered uneventfully. Our study shows that even in immunocompetent patients who present with non-resolving or worsening facial pain resembling the original diagnosis of TN, clinicians should remain vigilant for the possibility of alternative underlying pathologies including fungal sinusitis.