Doctors baffled over rare fungal disease

When Ezekiel Atoni, 68, started complaining of severe headache, nobody ever imagined it would escalate into a full-blown disease.

For nearly two years now, Atoni who has hails from Nyaramba village in Nyamira County, has spent most of his time battling for his life in various hospitals.

In February, he was airlifted to India and was admitted at the Apolos Hospital where he has undergone several surgeries. By the time we went to the press, his bill had shot to Sh5million.

Mzee Ezekiel Atoni before he fell ill.

“My father is ailing from fungal sinutisis. Specifically, doctors have identified it as chronic multiple fungal fulminant sinusitis,” his daughter, Judith Kwamboka said.

This is a rare condition that has left several doctors in the country baffled.

“When doctors discovered the disease at the Moi Teaching and Referral Hospital (MTRH), they were visibly surprised,” Kwamboka said.

Doctors at the referral hospital reportedly gathered around the patient and invited medical students to witness the rare discovery.

Dr Raymond Oigara who is a consultant surgeon based in Kisii says fungal sinutisis is a very rare condition.

“An ENT (Eye, Nose and Throat) specialist may be able to give you more information but I know that this is a rare disease,” Dr Oigara said.

Atoni had been to various hospitals in Nyamira and Kisii, with extremely severe headache being his greatest nightmare.

“He complained of severe headache and appeared to have been hit with a stroke. Soon, he could not close his mouth. His blood sugar levels were high but doctors in Kisii managed them,” Kwamboka said.

She said they later moved him to Cedar Hospital in Eldoret where he was subjected to CT scan and MRI examinations and a growth was discovered in his sinus.

“They first wanted to manage other conditions like headache. He used strong painkillers like morphine. Unfortunately while there, he lost sensation in the head and face. Some nerves were damaged and his right eye became blind,” she said.

The family was partially relieved when they were told that Atoni was not suffering from cancer, which had been their suspicion.

“They sent a sample to Lancet where it stayed for two months. The results came, indicating he had a focus and he was given drugs and discharged,” Kwamboka said.

Kwamboka said the condition worsened at home and his other eye started losing sight and he could not walk steadily.

“We were advised to seek further treatment. We came together as a family and friends, raised some money and took him to India,” she said.

“A sample was taken and cultured for a week where it was confirmed that it was not just a fungus. They told us it was chronic multiple fungal fulminant sinusitis,” she said.

Kwamboka said the father has had three surgeries so far and the bill was fast going up.

“We have already sold property and paid Sh2million. However, three weeks ago, he reacted to the medication and they had to suspend medication to monitor his kidneys,” she said.

Mzee Ezekiel Atoni at The Appolos Hospital in India

She said they had a balance of Sh3 million, with hopes that his stay in hospital will not be delayed any longer.

Research shows that when the body’s immune system is suppressed, fungi find an opportunity to invade it and a number of side effects occur.

“Because these organisms do not require light for food production, they can live in a damp and dark environment. The sinuses, consisting of moist, dark cavities, are a natural home to the invading fungi. When this occurs, fungal sinusitis results,” says the American Academy of Otolaryngology which adds that there are four types of fungal sinutitis.

A report by the Indian doctors showed that Atoni is ailing from both Fulminant Mucormycosis and Aspergillus Sinusitis

The conditions predisposing to mucormycosis type are diabetes mellitus, malnutrition, haematological malignancies, neutropenia, burns, surgical procedures, occlusive dressings, antibiotics, long-term steroid therapy, and immunosuppressive therap.

Successful management of this fulminant infection requires early recognition of the disease and aggressive medical and surgical interventions to prevent the high morbidity and mortality associated with the disease process.

Medics say successful treatment of Aspergillus includes early diagnosis, pre and post operative steroids and anti fungal therapy, surgical debridement of the polyps and caseous material with adequate drainage and ventilation along with control of the underlying disease.

The Mediscape online journal says that fungal infections of the sinuses have recently been blamed for causing most cases of chronic rhinosinusitis.

“The evidence, though, is still controversial. Most fungal sinus infections are benign or noninvasive, except when they occur in individuals who are immune compromised,” it says.

Pictures availed to us when Atoni was well and now revealed the toll the sickness had dealt him.

In his happy days, Atoni was bulky, energetic, jovial and hopeful. But the sickness has reduced him into a tiny man depending on others fully to see tomorrow.

“We are appealing to well wishers, friends, relatives and everyone else to hear our cry and help us return our father home,” Kwamboka said.

They have opened a pay bill number 396536 where help can be channeled to.

Leave a Reply