Aspergilloma in the frontal sinus expanding into the orbit.

Swoboda, Herwig; Ullrich, Robert C.

doi:10.1136/jcp.45.7.629

Cited by 26 publications

(29 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aspergillus species have been implicated in a wide variety of primary ocular orbital conditions, characterized by rapid, uncontrollable progression and sometimes death (201,374). Some presentations of orbital aspergillosis, such as optic nerve involvement, may lead to use of systemic corticosteroids, which delays the diagnosis and may potentiate the infectious process (213).…”

Section: Clinical Features Predisposing Factors and Management Of Smentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

View full text Add to dashboard Cite

Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors

show abstract

Section: Clinical Features Predisposing Factors and Management Of Smentioning

confidence: 99%

Current Perspectives on Ophthalmic Mycoses

2003

View full text Add to dashboard Cite

show abstract

“…Orbital or intracranial involvement commonly causes the first clinical signs. 4 Accordingly, our patients presented with nonspecific symptoms. A diagnosis of chronic sinusitis was suggested by our first patient's persistent frontal headache, fullness in the forehead and upper eyelid region, moderate nasal obstruction, and postnasal drip, and by our second patient's frontal headache and postnasal drip.…”

Section: Discussionmentioning

confidence: 99%

“…2 Such rarity can be explained by poor access to the frontal sinus for the mainstream of inhaled spores. 4 Our literature review identified only 20 cases of isolated frontal sinus fungus ball, reflecting the rarity of this disease.…”

Section: Discussionmentioning

confidence: 99%

“…Our first patient's symptoms were considered to indicate a possible frontal sinus mucocele, since frontal headache, fullness in the forehead and upper eyelid region, nasal Babinski et al 6 1 Bhalla et al 7 1 Chen & Chen 8 1 Dufour et al 2 4 Ferreiro et al 9 2 Gupta et al 10 1 Klossek et al 11 2 Kodama et al 12 1 Kumar et al 13 1 Panda & Reddy 14 2 Sekula et al 15 1 Stevens 16 1 Swoboda & Ullrich 4 1 Warder et al 17 1 Total 20 CLINICAL RECORD discharge, and obstruction are the most frequent clinical manifestations of this disease. 20 However, this patient's absence of previous trauma or surgery made this diagnosis unlikely.…”

Section: Discussionmentioning

confidence: 99%

“…The slow, asymptomatic development of frontal sinus fungus ball often leads to late diagnosis, usually with orbital or intracranial complications as a first clinical sign. 3,4 Intra-operative findings of dark brown, cheesy material are highly suggestive of a fungus ball. However, the diagnosis is most accurately made by microscopic detection of fungal material, such as dichotomous, branching hyphae, in smears.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Isolated fungus ball mimicking mucocele or frontal sinus tumour: a diagnostic pitfall

2009

View full text Add to dashboard Cite

Objective: To demonstrate the clinical, radiological and diagnostic pitfalls of managing an isolated frontal sinus fungus ball, and to compare with the literature.Material and methods: Retrospective analysis of two cases and literature review. Results: Isolated frontal sinus fungus ball is a rare cause of frontal sinus disease. We present two cases of isolated frontal sinus fungus ball which pre-operatively were suspected to be either a tumour or a mucocele. In both cases, cheesy, clay-like material was found intra-operatively within the frontal sinus, suggesting a fungus ball. Effective treatment included surgical debridement via an exclusively endoscopic or an external approach, variously. Final histopathological and mycological analysis revealed Aspergillus fumigatus. A literature review revealed 20 reported cases of isolated frontal sinus fungus ball, confirming the low prevalence of the disease.Conclusions: Frontal sinus fungus ball should be considered in the differential diagnosis of chronic, nonspecific forehead symptoms. To evaluate the underlying disease, computed tomography scans should first be performed, followed by magnetic resonance imaging if malignancy is suspected. It is essential to be aware of the possibility of an atypical fungus ball appearance on computed tomography and magnetic resonance imaging scans. If bony destruction and calcification coexist on radiological images, then endoscopic biopsy is an indispensable part of the diagnostic procedure, and should be performed to collect material for both histological and mycological analysis, and to aid surgical planning. In cases of sinus fungus ball, an endoscopic approach for biopsy may be curative.

show abstract

Oculomycosis

Thomas

Geraldine

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

View full text Add to dashboard Cite

Aspergilloma in the frontal sinus expanding into the orbit.

Cited by 26 publications

References 6 publications

Current Perspectives on Ophthalmic Mycoses

Current Perspectives on Ophthalmic Mycoses

Isolated fungus ball mimicking mucocele or frontal sinus tumour: a diagnostic pitfall

Oculomycosis

Contact Info

Product

Resources

About