An Invasive Aspergillosis with Large Orbital Abscess with Intracranial Extension in HIV Infection: A Case Report
Keywords:
aspergillosis, fungal infection, orbital abscess, orbital infection, invasive aspergillosisAbstract
Objective: To report an unusual finding of orbital invasive aspergillosis with intracranial involvement
Methods: We report a 40-year-old Thai female with human immune deficiency virus (HIV) infection presented with 1 month of left painful proptosis and complete visual loss. Orbital magnetic resonance imaging (MRI) depicted large abscess at posteromedial part of left orbit with intra-cranial involvement, and ipsilateral ethmoid sinusitis. Orbital abscess was urgently drained.
Results: Tissue biopsy from wall of the abscess revealed fungal hyphae which was confirmed as Aspergillus fumigatus from pus culture. Although prompt systemic antifungal drugs and aggressive sinus debridement were performed, patient underwent orbital exenteration.
Conclusions: This case demonstrates a large orbital abscess with intra-cranial involvement, an uncommon finding of invasive aspergillosis which might misdiagnose as other infection. Early tissue diagnosis should be done for the proper treatment.
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The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
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