Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 400-406 |
| Number of pages | 7 |
| Journal | Ophthalmic Plastic and Reconstructive Surgery |
| Volume | 23 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2007 Sep 1 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Ophthalmology
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Outcomes of three patients with intracranially invasive sino-orbital aspergillosis. / Yoon, Jin Sook; Park, Hyung Kyu; Cho, Nam Hoon; Lee, Sang Yeul.
In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 23, No. 5, 01.09.2007, p. 400-406.Research output: Contribution to journal › Article
TY - JOUR
T1 - Outcomes of three patients with intracranially invasive sino-orbital aspergillosis
AU - Yoon, Jin Sook
AU - Park, Hyung Kyu
AU - Cho, Nam Hoon
AU - Lee, Sang Yeul
PY - 2007/9/1
Y1 - 2007/9/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=34548820180&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548820180&partnerID=8YFLogxK
U2 - 10.1097/IOP.0b013e31814db448
DO - 10.1097/IOP.0b013e31814db448
M3 - Article
C2 - 17881994
AN - SCOPUS:34548820180
VL - 23
SP - 400
EP - 406
JO - Ophthalmic Plastic and Reconstructive Surgery
JF - Ophthalmic Plastic and Reconstructive Surgery
SN - 0740-9303
IS - 5
ER -