Fungus ball in the nasal cavity mimicking a rhinolith

A 63-year-old man presented to the outpatient department of our tertiary care hospital, with unilateral left nasal obstruction, foul smelling nasal discharge and occasional mild epistaxis. On examination, a hard greyish black mass was noted in the anteroinferior portion of the inferior turbinate, with extension posteriorly into the inferior meatus with surrounding unhealthy granulation tissue. Provisional diagnosis of rhinolith was surprisingly reversed by histopathology, which suggested the presence of an Aspergillus fungus ball with Actinomyces colonisation.