Intended for healthcare professionals

Endgames Spot Diagnosis

Chronic purulent nasal discharge

BMJ 2017; 357 doi: (Published 03 May 2017) Cite this as: BMJ 2017;357:j2061
  1. Zhenxiao Huang, consultant otolaryngologist,
  2. Jingying Ma, consultant otolaryngologist
  1. Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
  1. Correspondence to Z Huang zhenxiaohuang{at} or J Ma rebecca7481{at}

A 49 year old woman was referred to a community hospital after experiencing persistent purulent nasal discharge for three years. She had not responded to antibiotics. Subsequently, she was referred to a department of otolaryngology for surgical intervention. She underwent a non-contrast computed tomography (CT) scan of her sinuses (fig 1). Based on the CT scan, what is the diagnosis?

Fig 1 Coronal computed tomography (CT) scan of the sinus


A fungal ball, also known as a mycetoma, in the right nasal cavity.


The coronal sinus CT scan shows a fungal ball in the right nasal cavity …

View Full Text

Log in

Log in through your institution


* For online subscription