Outcomes of three patients with intracranially invasive sino-orbital aspergillosis

Jin Sook Yoon, Hyung Kyu Park, Nam Hoon Cho, Sang Yeul Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 languageEnglish
Pages (from-to)400-406
Number of pages7
JournalOphthalmic Plastic and Reconstructive Surgery
Volume23
Issue number5
DOIs
Publication statusPublished - 2007 Sep 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology

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