Case Study

CT – Mycotic rhinitis with conchal and turbinate destruction in a 12 year old FS English Sheepdog

This 12 year old FS English Sheepdog has a hisotyr of nasal bleeding of 2 months duration

DX

The findings are consistent with mycotic rhinitis and destruction of the conchal and turbinate structure in the left nasal cavity and emerging destruction in the right nasal cavity.

Image Interpretation

CT of the skull:

In the left nasal cavity there is a moderate amount of non-gravity dependent, noncontrast enhancing material present attached to the nasal turbinates. In the left frontalsinus and the nasopharynx a mild amount of gravity dependent material is present, demarcated by a horizontal fluid line. There is marked destruction of the conchal and turbinate structures in the left nasal cavity – consistent with an emerging “empty nose”. Mild turbinate destruction is noted within the right nasal cavity as well. The mucosal lining of the nasal cavity is moderately thickened with mildly increased contrast enhancement. The bony lining of the left nasal cavity presents multifocal mild hyperostosis and increased sclerosis. Small focal osteolytic areas are also noted.

Outcome

As infectious agent Aspergillus is very likely.
Secondary reactive lymphadenitis left medial retropharyngeal lymph node is noted. Recommend rhinoscopy for further evaluation with sampling for culture and
histopathology (detection of fungi is more straightforward microscopically than with
culture in many cases) followed by antifungal therapy.