Intracranial and orbital aspergillosis in immunocompetent patient

Iyeyasu, Josie Naomi; Reis, Fabiano; Altemani, Albina; Carvalho, Keila Monteiro de

doi:10.1590/s0004-282x2011000100026

Cited by 3 publications

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“…Intracranial extension often results in mortality despite therapy. Nonetheless, invasive sino-orbital aspergillosis may occur in immunocompetent patients (3, 17, 18, 29, 30, 32, 35, 43). The standard treatment for invasive sino-orbital disease has been radical surgical intervention, including orbital exenteration, sinus excision, and aggressive intracranial debridement (9, 13, 22, 31).…”

Section: Introductionmentioning

confidence: 99%

Acute Chiasmal Abscess Resulting from Perineural Extension of Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

et al. 2014

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OBJECTIVE Intracranially invasive sino-orbital aspergillosis is a rare entity seen predominantly in immunocompromised individuals. We report a unique case of an acute chiasmal abscess resulting from perineural extension of an indolent invasive sino-orbital aspergillosis in an immunocompetent patient. CASE DESCRIPTION A 61-year-old healthy Ukrainian man presented with severe left retro-orbital pain and a gradual ipsilateral monocular vision loss with rapid progression to a contralateral temporal visual field cut. He was found to have an intracranially invasive sino-orbital Aspergillus fumigatus infection with perineural extension along the optic nerve complicated by an acute chiasmal abscess. RESULTS The patient was managed with surgical debridement and adjuvant antifungal chemotherapy. The patient’s life and vision were preserved. CONCLUSIONS The case demonstrates that it is possible to successfully control advanced intracranial aspergillosis with tissue-sparing surgery and adjuvant antifungal chemotherapy in immunocompetent individuals.

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Section: Introductionmentioning

confidence: 99%

Acute Chiasmal Abscess Resulting from Perineural Extension of Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

et al. 2014

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Intracranial aspergillosis amongst immunocompetent patients: An experience with combined surgical and medical management of 18 patients

Bora

Kumar

Mishra

et al. 2019

Clinical Neurology and Neurosurgery

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Management of granulomatous cerebral aspergillosis in immunocompetent adult patients: a review

Ellenbogen

Waqar

Cooke

et al. 2016

British Journal of Neurosurgery

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Cerebral aspergillosis, is an infrequent, opportunistic infection of the central nervous system that accounts for 5-10% of all intracranial fungal pathology. It is uncommon in immunocompetent patients and has a significant disease burden, with high morbidity and mortality, even with appropriate treatment. Basic principles of abscess management should be employed, including aspiration and targeted anti-fungal therapy for 12-18 months. However, reported outcomes with a purely minimally invasive approach are poor and there should be a low threshold for surgical excision, especially in resource poor settings and in patients with deteriorating neurology harbouring sizeable masses. Evidence favouring gross total excision over subtotal resection is lacking, however. It is notable that these recommendations are largely based on retrospective case series and isolated case reports. There is a need therefore for international collaboration to evaluate management strategies for immunocompetent patients with cerebral aspergillosis.

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Intracranial and orbital aspergillosis in immunocompetent patient

Cited by 3 publications

References 0 publications

Acute Chiasmal Abscess Resulting from Perineural Extension of Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

Acute Chiasmal Abscess Resulting from Perineural Extension of Invasive Sino-Orbital Aspergillosis in an Immunocompetent Patient

Intracranial aspergillosis amongst immunocompetent patients: An experience with combined surgical and medical management of 18 patients

Management of granulomatous cerebral aspergillosis in immunocompetent adult patients: a review

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