Abstract: A 70 year old female camewith complains of persistent nasal discharge since 4 days & spontaneous fall of tooth 4 days back. Patient was a known case of Rheumatoid arthritis since 30 years being on steroidal injections. Patient had left unilateral hypertrophied thick & congested inferior turbinate. Deviating nasal septum to right. Oro-antral fistula was seen.Lactophenol cotton-blue mount showed septate hyphae with acute angle branching &single celled conidia.Patient was effectively treated with voriconazole.