A Case of Invasive Paranasal Aspergillosis with Opthalmopathy
| Autor: | Mikio Hirotsu, Katsuhisa Ikeda, Akira Minekawa, Kaori Kase, Takeshi Kusunoki |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Aspergillus genetic structures medicine.diagnostic_test biology business.industry Mortality rate medicine.disease Aspergillosis biology.organism_classification eye diseases Surgery medicine.anatomical_structure Otorhinolaryngology Ptosis Biopsy medicine Optic nerve Oculomotor nerve palsy medicine.symptom business Sinus (anatomy) |
| Zdroj: | Practica oto-rhino-laryngologica. Suppl.. 126:21-24 |
| ISSN: | 2185-1557 0912-1870 |
| DOI: | 10.5631/jibirinsuppl.126.21 |
| Popis: | Invasive paranasal aspergillosis has been considered to have a poor prognosis. We report a case of orbital apex syndrome due to left ethmoid-sphenoid aspergillosis. A 76-year-old woman with untreated diabetes mellitus, presented with left visual disturbance, oculomotor nerve palsy, ptosis and orbital pain. CT and MRI showed cloudy images with defects of the bone wall in the left posterior ethmoidal sinus. The serological examination revealed aspergillus antigen (+) and high levels of β-D glucan. Therefore, we diagnosed paranasal aspergillosis, and administrated voriconazol preoperatively as an antifungal agent. The patient underwent left ethmoid-sphenoidectomy and biopsy via the endonasal approach. In the histopathologic examination, aspergillus was found around the optic nerve canal. At the present, continucus administration of voriconazol has improved the patient's ptosis and orbital pain, but not her visual disturbance. This case suggests that invasive paranasal aspergillosis has the possibility of visual loss and high mortality rate so that he needs early diagnosis and treatment. |
| Databáze: | OpenAIRE |
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