Orbital Aspergillosis In Immunocompetent Patients

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Intracranial and orbital aspergillosis in immunocompetent patient

Intracranial and orbital aspergillosis in immunocompetent patient Josie Naomi Iyeyasu1, Fabiano Reis2, Albina Messias Altemani3, Keila Monteiro de Carvalho4 Correspondence Josie Naomi Iyeyasu Rua Tenente Mauro de Miranda 96 /102 04345-030 São Paulo SP - Brasil E-mail: [email protected] Received 12 July 2010 Received in final form 21

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4 Mody KH, Ali MJ, Vemuganti GK, et al. Orbital aspergillosis in immunocompetent patients. Br J Ophthalmol 2014;98:1379 84. 5 Fili M, Lundell G, Lundell M, et al. High dose rate and low dose rate ruthenium brachytherapy for uveal melanoma. No association with ocular outcome. Br J Ophthalmol 2014;98:1349 54.

Invasive aspergillosis in a user of inhaled cocaine

Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin,

The Case of Painful Vision Loss - aao.org

typical of orbital fungal infection in immunocompromised patients, our patient experienced a slowly progres-sive course despite his HIV status and chronic steroid treatment. A wide spectrum of disease. Four main patterns of Aspergillus infection have been characterized.1 Fulminant aspergillosis with vascular and soft

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immunocompetent patients. Most orbital fungal infections are aspergillosis and mucormycosis. Aspergillus flavus is the organism most frequently isolated.7 The disease often presents late, at advanced stages, due to the paucity of symptoms in the initial period. Clinical presentation is mainly due to the mass effect, commonly with nasal complaints


organism on culture. Orbital erosion was seen in 78% and skull base erosion was observed in 9%. Recurrence of disease was seen in nine cases. Conclusion: Allergic fungal sinusitis (AFS) is a disease of young immunocompetent adults. Nasal obstruction, nasal discharge, nasal allergy and proptosis were the most common presentations.

Subramanyan et al, J Clin Case Rep 21, : R Journal of

The most frequent fungal agent that causes rhinosinusitis is Aspergillus. Orbital apex syndrome due to mucormycosis, aspergillosis have been reported earlier. It is also common in immunocompromised patients. In the immunocompromised patient, there has been an increased incidence of invasive aspergillosis in the last 20 years.

Mucormycosis: its contemporary face and management strategies

is patients with uncontrolled diabetes.15 In immunocompetent patients, Apophysomyces elegans has emerged as an important pathogen for mucormycosis, leading to primarily cutaneous and rhino-orbital-cerebral disease with infections and generally occurring after traumatic inoculation.16 18 Additionally, several studies

Intracranial Aspergilloma in Immunocompetent Patients

immunocompromised patients. 2 Siddiqui et al 3 had classi-fied them into 3 types. Type 1 is patients with intracerebral aspergillosis that was associated with the worst clinical outcome. Type 2 is patients with orbital and cranial base aspergillosis who had a good recovery. Type 3 is patients with intracranial extradural aspergillosis where

SHORT REPORT Central nervous system Aspergillus fumigatus

CNS aspergillosis is a rare condition in immunocompetent hosts, and is favoured by working in agriculture, craftwork, and by a tropical climate.5 In patients with few risk factors, the entire disease period can last from 9.5 months to four years.5 Diabetes mellitus type II seems to be a predisposing

Medical Mycology Case Reports

Rhino-orbital mucormycosis was suspected, and on day þ1an extensive unilateral endoscopic nasosinusal surgery was per-formed, with debridement of anterior and posterior ethmoidal cells, opening of the maxillar antrum and extensive removal of invaded mucosa in the right sphenoidal sinus. Furthermore resec-

A retrospective analysis of eleven cases of invasive rhino

fungal orbital infection important to understand is sino-orbital aspergillosis. Sino-orbital Aspergillus in-fection can occur acutely or chronically and can affect both the immunocompetent and immunocomprom-ised [21, 22]. Invasive Aspergillus infection in the immunocompetent host usually presents in a more indolent but progressive course. CT

Update in Pathological Diagnosis of Orbital Infections and

healthy immunocompetent patients who lack the risk factors associated with the contact of the health care environment.13 A retrospective review of pediatric orbital cellulitis found that Staphylococcus species was the most common organism isolated followed by the Streptococcus species. This study found 73%

Invasive fungal disease misdiagnosed as tumour in association

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


age.2 Rare cases have been reported in immunocompetent individuals. Aspergillus fumigatus is the commonest species encountered in invasive aspergillosis.2 The specific diagnosis of invasive sino-orbital aspergillosis is often delayed as it may mimic a number of infectious and inflammatory conditions like

Review 3 Harmful fungi in both Agriculture and Medicine

nary aspergillosis [13,227]. Invasive aspergillosis is a major cause of death in immunocompromised patients, with the associated mortality rate > 90% [48,180]. a) Aspergillus infections in healthy individuals. As with members of the genus Fusarium, some of the Aspergilli can cause infections in immunocompetent per-sons who may, or may not

Orbital Complication of Allergic Fungal Rhino-sinusitis

orbital complications due to allergic fungal rhino-sinusitis. METHOD Sixty patients were reviewed from 2010 to 2013. All patients were diagnosed and treated for allergic fungal rhino-sinusitis. The diagnosis was based on Bent Kuhn criteria and analysis of CT scan reports of these patients.

Sino-Orbital and Cerebral Aspergillosis: Cure with Medical

pulmonary aspergillosis occurs almost entire- ly in immunocompromised patients, whereas sino-orbital infection is most frequently seen in immunocompetent hosts (6, 12, 14, 27). Treatment of aspergillosis in an im- munocompetent host may be more likely to succeed than treatment in an immunocom- promised host.

Errol Wei en Chan MBBS, Srinivasan Sanjay MS(Ophth), Benjamin

out hypopyon. Proptosis and orbital bruit were absent. There were no external changes in the ears, and the tympanic mem-branes in both ears were normal. A complete blood count and erythrocyte sedimentation rate were within normal limits. Lumbar puncture showed clear cerebrospinal fluid and an opening pressure of 16 (nor-mal 10 20) cm water.

Orbital Aspergillosis: Voriconazole - The New Standard Treatment?

orbital aspergillosis is typically found in diabetics, corticosteroid users, and immunocompetent individuals. There is typically a sparse immune response resulting in a slow indolent course. Patients often present with a chronic, dull retrobulbar pain present for months, headache, red eyes, and proptosis. Over time, these symptoms may

Orbital mucormycosis in immunocompetent children; review of

Orbital mucormycosis in immunocompetent children; review of risk infections following candidiasis and aspergillosis [1]. Summary characteristics of patients


Orbital cellulitis 8. Ear, Nose and Oropharynx in immunocompetent patients Herpes zoster (shingles) in immunocompetent patients Aspergillosis

Chronic Invasive Aspergillosis in Apparently Immunocompetent

normal hosts have been reviewed: 9 of invasive sinus aspergillosis, 2 of isolated brain abscesses, 3 of pneumonia (1 in a patient who developed mediastinitis), 2 of lymph node aspergillosis, and 1 of osteomyelitis of the foot. Two of the 9 patients with sinus aspergillosis died; the rest were stable up to March 1993.

Guidelines for Antimicrobial Prescribing - QE

Orbital cellulitis 8. Ear, Nose and Oropharynx in immunocompetent patients Herpes zoster (shingles) in immunocompetent patients Aspergillosis

Craniocerebral aspergillosis in immunocompetent hosts

although the pathology conÞ rmed this to be aspergillosis. Patient was immunocompetent 3 4 5 Figure 6: Axial T1 weighted image with gadolinium enhancement showing nasal and left orbital involvement with left proptosis. Patient also has a left temporal ring-enhancing abscess in the absence of bony erosion.

l & E x perimenta l i n ic lp Journal of Clinical

The incidence of Invasive sino-orbital aspergillosis in immunocompetent patients is rare, with only 21 cases found in the English literature since 1966 [6]. Aspergillosis often presents with vague complaints and the absence of clinical findings, making diagnosis difficult. Subsequently, treatment may be delayed, or steroids

Skull base aspergillosis in an immunocompetent elderly man

Steroid-responsive primary aspergillosis of the orbital apex has been reported previously, as well as CNS aspergillosis in immunocompetent patients.1 6 8 10 However, the initial presenta-tion of apparent steroid-responsive atypical optic neuritis, with normal initial enhanced MRI, normal CSF and inflammatory markers, is unreported.

A case series of unilateral orbital aspergillosis in three

aspergillosis, sino-orbital infection is considered a local dis-ease which can develop in immunocompetent feline patients. Fifteen cases of localized nasal or orbital aspergillosis have been reported previously.1 9 Of these cases, only one cat was suspected of being immunosuppressed (due to diabetes mell-


Orbital cellulitis 8. Ear, Nose and Oropharynx in immunocompetent patients Herpes zoster (shingles) in immunocompetent patients Aspergillosis

Isolated fungus ball in sphenoid sinus: tips and pitfalls of

cally affecting immunocompetent patients, with no evidence of tissue invasion. 5,7 Paranasal sinus FB was first described in the 18th century and defined as extramucosal accumulation of dense conglomeration of fungal hyphae in a solitary sinus cavity.8 FB usually affects elderly immunocompetent patients (mean age of 64

Invasive zygomycosis in India: experience in a tertiary care

diagnosis is disseminated aspergillosis. c Renal type: isolated renal zygomycosis is rare. In India most cases have been reported in immunocompetent hosts. They present with unilateral or bilateral flank pain, and fever with haematuria or anuria. On CT scan enlarged and infarcted kidneys are observed. CT or ultrasound guided needle

SUNY Downstate Grand Rounds April 14, 2016

Aspergillosis Acute invasive: fulminant sinus infection with secondary orbital invasion severe infection in immunosuppressed patients aggressive management with surgical excision and administration of amphotericin B, flucytosine, rifampin, or a combination Septate branching hyphae of uniform width on Grocott-Gomori

A rare cause of invasive fungal sinusitis-Pseudallescheria boydii

(Table 2). This data suggests that the prognosis of immunocompetent patients is much better than immunosuppressed patients. Mimicking the clinical and histologic features of invasive aspergillosis, infections due to these pathogens are often resistant to conventional amphotericin B. 85% of the isolates in immunocompromised hosts were resistant

Concepts and principles of photodynamic therapy as an

cially in immunocompromised and debilitated patients. Invasive mycoses represent an exponentially growing threat for human health due to a combination of slow diagnosis and the existence of relatively few classes of available and effective antifungal drugs. Therefore systemic fungal infections result in high attributable mortality. There is an

Therapeutic effects of pentoxifylline on invasive pulmonary

on invasive pulmonary aspergillosis in immunosuppressed mice Chunlai Feng1*, Ming Zhang1, Sujuan Zhang1, Jun Zhang2, Chong Li1 and Jun Zhou1 Abstract Background: The most common and severe infection of Aspergillus fumigatus is invasive pulmonary aspergillosis (IPA), which is usually seen in immunocompromised patients.

Zinc-Regulated Biosynthesis of Immunodominant Antigens from

monary aspergillosis [ABPA]) in normal hosts and invasive or disseminated infections in immunosuppressed patients (16). Immunocompetent affected individuals often have high levels of antibodies directed at fungal components. Although these antibodies may not always provide an effective defense against

Sino-orbital Aspergillosis in Acquired Immunodeficiency Syndrome

in immunocompetent and immunocom-promised patients.2-4 Recently, the asso-ciation between acquired immunodefi-ciency syndrome (AIDS) and sino-orbital aspergillosis has been described.1,5-8 We reviewed 5 patients with sino-orbital as-pergillosis and AIDS and studied the pre-disposing factors, clinical presentations,

Clinical science - BMJ

Conclusions Though orbital aspergillosis is commonly seen in immunocompromised patients, it should be suspected in young immunocompetent individuals presenting with proptosis of insidious onset and infiltrating lesions involving the paranasal sinuses. Definitive diagnosis is achieved by histopathological and microbiological evaluation.

Orbital aspergillosis: a case report and review of the literature

Abstract Background: Orbital aspergillosis is a rare sight- and life-threatening fungal infection affecting immunocompromised or otherwise healthy patients. It is often misdiagnosed due to its unspecific clinical and radiologic appearance. Therapeutic delay can have dramatic consequences.


aspergillosis of orbit in immunocompetent patients: treatment and outcome. Ophthalmology 2011;118:1886 1891. 3. Saini J, Gupta AK, Jolapara MB et al. Imaging findings in intracranial aspergillus infection in immuocompetent patients. World Neurosurg 2010 Dec;74(6):661-70. 4. Chawla B, Sharma S, Kashyap S et all. Primary orbital