Clinical characteristics and prognosis of orbital invasive aspergillosis

PURPOSE: To evaluate the clinical characteristics and prognosis of orbital invasive aspergillosis, a major cause of morbidity and mortality in immunocompromised patients. METHODS: Review of the medical records of Severance Hospital, Yonsei University College of Medicine, from 1995 to 2007 revealed 15 patients with orbital invasive aspergillosis. A retrospective cohort study was conducted to evaluate the clinical characteristics, radiologic findings, associated underlying diseases, and prognosis. Risk factors for mortality were analyzed. RESULTS: A total of 15 cases of orbital invasive aspergillosis were included in this study. The mean age for all patients was 61.9 years. The most common underlying disease was diabetes mellitus and all patients had paranasal sinus infections. The most common ocular symptoms were visual disturbance, periorbital swelling, and periorbital pain. The mortality rate associated with invasive aspergillosis was 40%. According to univariate analysis, variables significantly associated with invasive aspergillosis-related mortality included fever and incorrect initial diagnosis. CONCLUSIONS: Fever and incorrect initial diagnosis were found to be associated with high mortality rates in patients with orbital invasive aspergillosis. Further study is necessary to determine optimal strategies for early diagnosis and appropriate treatment.