Cavernous sinus-orbital apex aspergillus infection in a diabetic patient: A case report. Issue 13 (March 2019)

• Record Type: Journal Article
• Authors: Huang, Yuanyuan; Gui, Li
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 98:Issue 13(2019)
• Publication Date: 2019-03
• Subjects: aspergillosis -- cavernous sinus -- orbital apex -- rhinosinusitis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000015041
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Cavernous sinus-orbital apex aspergillosis is a rare but serious complication of rhinosinusitis. Pathology results are scarce, and this condition is difficult to diagnose based on clinical and radiological results. Patient concerns: A 64-year-old woman presented with cavernous sinus-orbital apex syndrome. Axial and sagittal T1 contrast-enhanced magnetic resonance imaging (MRI) showed a right orbital apex mass abutting the right posterior ethmoid sinus, sphenoid sinus, and cavernous sinus. Diagnosis: Cavernous sinus and orbital apex aspergillosis. Interventions: Functional endoscopic sinus surgery was performed, and a biopsy of the lesion tissue was submitted for examination, which showed the presence of aspergillus. Outcomes: One year after surgical debridement, antifungal, and anticoagulation treatments, the patient is still asymptomatic without recurrence. Lessons: Early surgical debridement is crucial to confirm the diagnosis of cavernous sinus-orbital apex aspergillosis and prevent mortality. There is no evidence of negative effects of antibiotic and anticoagulation treatments. Despite controversy, among physicians, most opt to treat patients via anticoagulation therapy.