Fungal pan-sinusitis with severe visual loss in uncontrolled diabetes.
- Author:
Jocelyn L L CHUA
1
;
James F CULLEN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Antifungal Agents; therapeutic use; Antigens, Fungal; analysis; Aspergillosis; complications; diagnosis; therapy; Aspergillus; immunology; isolation & purification; Debridement; methods; Diabetes Complications; blood; complications; therapy; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Mucormycosis; complications; diagnosis; therapy; Rhizopus; immunology; isolation & purification; Sinusitis; complications; diagnosis; therapy; Tomography, X-Ray Computed; Vision, Low; diagnosis; etiology; therapy
- From:Annals of the Academy of Medicine, Singapore 2008;37(11):964-967
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONInvasive fungal pan-sinusitis can present atypically with severe acute visual loss with minimal anterior orbital inflammation. We describe 2 such cases with a background of uncontrolled diabetes.
CLINICAL PICTURERespective clinical presentations of orbital apex and cavernous sinus syndromes were associated with isolation of Aspergillus galactomannan and Rhizopus.
TREATMENTUrgent extensive surgical debridement and systemic antifungal is necessary.
OUTCOMEClinical improvement of the ocular motor nerves can be expected within 2 months of treatment but visual loss is usually permanent.
CONCLUSIONUnderlying pansinusitis is an important differential for acute visual loss, especially in uncontrolled diabetics. Early treatment determines outcome.
