OBJECTIVE: To report a case of chronic sinusitis by Histoplasma capsulatum in a patient treated at the Hospital Regional of Presidente Prudente in November of 2011. CASE REPORT: ADC, 75 years old, female, born and resident of Santo Atanasio - SP, diabetic, hypertensive, with heart failure, had episodes of front temporal headache for about 3 months progressing to moderate intensity and fall of the usually for 30 days associated with nasal obstruction and postnasal drip. She had no systemic complaints. She was conducted outpatient treatment with antibiotics of various classes, with no improvement. On examination, there was granulomatous lesion with areas of fibrin and necrotic, yellowish nasal discharge and severe edema of the nasal mucosa, the signs proven Fibronasolaryngoscopy. She was submitted to the hospital for diagnosis and specialized treatment. To the Computed tomography of the sinuses, soft material partially filling all sinuses of nasal septum deviation to the left. After use of intravenous levofloxacin, there was no improvement in clinical condition, being held Fibronasolaryngoscopy for reassessment, and nasal mucosa biopsy for fungi and bacteria. Concomitantly, was accompanied by Cardiology for cardiac instability, evolving to cardiogenic shock and death. Culture results showed suppurative granulomatous chronic inflammatory process infected by fungi (Histoplasmosis) with negative BAAR. CONCLUSION: Chronic sinusitis is a fungal disease that simulates insidious and nonspecific bacterial, usually treated with antibiotics. Therefore, the otolaryngologist should be alert for early diagnosis of unusual agents in the etiology of rhinosinusitis.