| Outcomes of three patients with intracranially invasive sino-orbital aspergillosis. | |
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MedLine Citation:
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PMID: 17881994 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Although rare, invasive aspergillosis with intracranial spread usually is fatal and necessitates prompt diagnosis and treatment. We describe the prognoses for survival and vision in 3 consecutive patients with vision-threatening invasive sino-orbital aspergillosis. METHODS: A case series of 3 patients, with review of treatments and outcomes. RESULTS: Three diabetic patients presented with significant eye pain and headache, followed by progressive ophthalmic symptoms including vision loss and limitation of ocular motility. Histologic examination showed numerous hyphae of Aspergillus fumigatus. Following early diagnosis and surgical debridement, 1 patient (case 1) showed vision improvement, from counting fingers to 20/20. The other 2 patients, who were initially treated with corticosteroids after presumptive diagnoses of nonspecific orbital inflammation, showed no recovery of vision from no light perception, and 1 (case 3) died of massive intracranial spread and side effects of antifungal agents caused by delayed diagnosis and long-term use of corticosteroids. CONCLUSIONS: Invasive sino-orbital aspergillosis with intracranial invasion often may resemble inflammatory conditions. Early diagnosis and surgical intervention are required to improve vision and survival. Repeated biopsies often are necessary to rule out fungal sinus infection before considering steroid use, especially in diabetic patients. |
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Authors:
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Jin Sook Yoon; Hyung Kyu Park; Nam Hoon Cho; Sang Yeul Lee |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Ophthalmic plastic and reconstructive surgery Volume: 23 ISSN: 0740-9303 ISO Abbreviation: Ophthal Plast Reconstr Surg Publication Date: 2007 Sep-Oct |
Date Detail:
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Created Date: 2007-09-20 Completed Date: 2008-01-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8508431 Medline TA: Ophthal Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 400-6 Citation Subset: IM |
Affiliation:
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Department of Ophthalmology (The Institute of Vision Research), Yonsei University College of Medicine, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anti-Bacterial Agents / therapeutic use Aspergillosis / drug therapy, microbiology*, radiography Aspergillus fumigatus / isolation & purification Brain Diseases / drug therapy, microbiology*, radiography Debridement Eye Infections, Fungal / drug therapy, microbiology*, radiography Fatal Outcome Female Humans Itraconazole / therapeutic use Magnetic Resonance Imaging Male Middle Aged Orbital Diseases / drug therapy, microbiology*, radiography Paranasal Sinus Diseases / drug therapy, microbiology*, radiography Pyrimidines / therapeutic use Tomography, X-Ray Computed Treatment Outcome Triazoles / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 0/Pyrimidines; 0/Triazoles; 0/voriconazole; 84625-61-6/Itraconazole |
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