Invasive fungal disease misdiagnosed as tumour in association with orbital apex syndrome.
BMJ Case Rep
; 14(1)2021 Jan 20.
Article
in En
| MEDLINE
| ID: mdl-33472802
ABSTRACT
Invasive sino-orbital aspergillosis is a rare cause of orbital apex syndrome (OAS) in immunocompetent patients and often misdiagnosed as tumour because of its aggressive nature and invasive patterns. We report a 23-year-old immunocompetent man presenting with painful progressive loss of vision, ophthalmoplegia and proptosis of the right eye suggestive of OAS. MRI with gadolinium contrast showed an enhancing heterogeneous mass filling the paranasal sinuses, extraconal space and extending up to the right orbital apex. A functional endoscopic biopsy reported as invasive sino-orbital aspergillosis. He was started on intravenous voriconazole and maximal surgical debridement was done. He gradually regained his vision to 20/30 in the right eye. A review of literature reported several such cases which were managed medically or surgically but with poor visual recovery. This case highlights the need for awareness among clinicians for early diagnosis and treatment to prevent vision loss and better survival.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Orbital Diseases
/
Aspergillosis
/
Sinusitis
/
Orbital Neoplasms
/
Diagnostic Errors
/
Invasive Fungal Infections
Type of study:
Diagnostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
BMJ Case Rep
Year:
2021
Document type:
Article
Affiliation country:
India