Long standing foreign body mimicking fungal sinusitis

Objective: Foreign body within ethmoidal sinuses is uncommon and its presentation as chronic cough is even less common. In a patient presenting with nasal polyposis with CT features of hyper densities in a homogenously opacified sinus, the suspicion of fungal sinusitis is high. We present a case where multiple foreign bodies primarily in the ethmoid sinus mimicked fungal sinusitis. Case report: Patient presented with persistent dry cough, blood tinged discharge from mouth and repeated throat clearing for the last one year. He gave a history of a road traffic accident 5 years ago with minor abrasions on the nose but no open wounds. Nasal endoscopy revealed polypoidal mucosa bilaterally in the middle meati and polyp in left sphenoethmoidal recess. CT scan of the paranasal sinuses revealed multiple dense opacities in bilateral ethmoidal sinuses. During Nasal endoscopic sinus surgery multiple wooden foreign bodies with underlying polypoidal mucosa were noted in both ethmoidal sinuses. Conclusion: Foreign body ethmoid sinuses are relatively uncommon with diagnosis mimicking other common conditions such as fungal sinusitis or tumors, especially when there is no history of penetrating injury.