Invasive fungal sinusitis

An extensive enhancing irregular low T2 intensity mucosal thickening involving bilateral maxillary , ethmoid, sphenoid sinuses with retention cysts / polyps are noted in the bilateral maxillary , sphenoid sinuses – likely suggestive of invasive fungal sinusitis in the given clinical settings.

Subtle abnormal soft tissue involving right foramen Rotundum, optic canal extending around anterior clinoid process with features of right optic neuritis, related to fungal invasion

Extensive low T2 intensity irregularly marginated altered signal intensity lesion involving the right capsuloganglionic region, basifrontal lobe extending superiorly along the right anterior parafalcine cortex with invasion of genu, anterior body of corpus callosum to the right of midline further extending to the contra lateral (left) frontal lobe with restricted diffusion on DWI involving the entire lesion – suggestive of fungal cerebritis

Multiple tiny areas of restricted diffusion in bilateral anterior, superior frontal lobe, centrum semiovale suggestive of cerebral infarct and septic emboli

Complete lack of fluid along the course right anterior cerebral artery, likely related to angioinvasion and related thrombosis.

No evidence of midline shift
Features suggestive of SINONASAL-ORBITAL-CEREBRAL-MUCORMYCOSIS