Orbital aspergillus infection diagnosed by FNAC

Kuruba, Sree Lakshmi; Prabhakaran, Venkatesh C; Nagarajappa, A. H.; Biligi, Dayanand

doi:10.1002/dc.21488

Cited by 9 publications

(3 citation statements)

References 9 publications

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“…In the eye, the main role of fibroblasts is the repopulation of acellular areas during the repair process and the regulation of inflammation during infection or surgical procedures [ 29 ]. The eye is constantly exposed to viruses, bacteria, and fungi [ 30 , 31 , 32 , 33 , 34 ], but rapid elimination mechanisms (e.g., the mechanical effect of tears and the presence of substances exhibiting microbicidal activity, such as lysozymes) often prevent the eye from becoming infected. However, alterations in the epithelial surface caused by trauma or by a decrease in the local or systemic immunological system can leave the eye vulnerable to infection.…”

Section: Discussionmentioning

confidence: 99%

Defensin Production by Human Limbo-Corneal Fibroblasts Infected with Mycobacteria

et al. 2013

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Epithelial cells of the cornea and the conjunctiva constitutively produce antimicrobial peptides; however, the production of defensins by other cell types located around the eye has not been investigated. We analyzed the production of beta-defensins (hBD) and cathelicidin LL-37 during the infection of primary limbo-corneal fibroblasts with M. tuberculosis (MTB), M. abscessus (MAB), and M. smegmatis (MSM). The intracellular survival of each mycobacterium, the production of cytokines and the changes on the distribution of the actin filaments during the infection were also analyzed. Fibroblasts produce basal levels of hBD1 and LL-37 and under PMA stimulation they produce hBD2, hBD3 and overexpress hBD1 and LL-37. MAB induced the highest levels of hBD1 and LL-37 and intermediate levels of IL-6; however, MAB was not eliminated. In addition, MAB induced the greatest change to the distribution of the actin filaments. MTB also produced changes in the structure of the cytoskeleton and induced low levels of hBD1 and IL-6, and intermediate levels of LL-37. The balance of these molecules induced by MTB appeared to contribute to the non-replicative state observed in the limbo-corneal cells. MSM induced the lowest levels of hBD1 and LL-37 but the highest levels of IL-6; MSM was eliminated. The results suggest that mycobacterial infections regulate the production of antimicrobial peptides and cytokines, which in conjunction can contribute to the control of the bacilli.

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Section: Discussionmentioning

confidence: 99%

Defensin Production by Human Limbo-Corneal Fibroblasts Infected with Mycobacteria

et al. 2013

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“…We used a biopsy taken from the nasal cavity and fungal culture to confirm the diagnosis of AIFR. A study by Kurubor et al 31 confirmed the efficiency of fine-needle aspiration cytology in making an early diagnosis of AIFR.…”

Section: Discussionmentioning

confidence: 90%

Orbital Complications of Acute Invasive Fungal Rhinosinusitis: A New Challenge in the COVID-19 Convalescent Patients

Tadros¹,

Tomoum²,

Shafik³

2022

OPTH

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Purpose Increased incidence of acute invasive fungal rhinosinusitis (AIFR) in the setting of COVID-19 is undeniable. This can be attributed to its effect on innate immunity and extensive use of corticosteroids. The goal of our study was to assess the orbital complications of AIFR and its management in the COVID-19 convalescent patients. Methods Our longitudinal prospective study included 45 patients with orbital complications of AIFR in recently recovered COVID-19 patients. We performed otorhinolaryngological, ophthalmological, and neurological examinations to monitor the manifestations of the disease. Computed tomography and contrast enhanced magnetic resonance imaging were performed to detect the extent of infection. Antifungal medications, surgical intervention, and general condition management were all provided to all the patients. Results We reported pre-septal cellulitis, orbital cellulitis, and orbital apex syndrome in 18, 13, and 10 patients, respectively. Four patients had cavernous sinus thrombosis. Mucormycosis and Aspergillus species were detected in 80% and 11.11% of our patients, respectively, while the mixed infection was found in 8.88% of our patients. Diabetes mellitus was the most common cause of immunocompromise (95.55% of our patients). Orbital pain and ophthalmoplegia were the most common ocular manifestations, followed by proptosis and relative afferent pupillary defect. All patients underwent surgical intervention, except for one patient who was unfit for surgery. One patient had orbital exenteration. The ophthalmological manifestations were reversible in cases of orbital and pre-septal cellulitis. The overall survival rate was 66.67%. Conclusion Early diagnosis and treatment of AIFR can decrease the morbidity and mortality rate of affected patients.

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“…Fine needle aspiration cytology (FNAC) is well documented as a diagnostic tool in fungal infection involving other body parts, but is not commonly performed to investigate orbital lesions. Kuruba et al [7] presented 2 cases of fungal infection of orbital and periorbital tissue diagnosed by FNAC and suggested the role of FNAC in making an early diagnosis of orbital aspergillosis, thereby allowing early therapy in these patients.…”

Section: Discussionmentioning

confidence: 99%

Combined Lateral Orbitotomy and Endoscopic Transnasal Orbital Decompression in a Case of Orbital Aspergillosis with Impending Intracranial Invasion

Chan

Lee

et al. 2012

Case Rep Ophthalmol

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A 64-year-old man with a known history of diabetes and hypertension presented to the Accident and Emergency Department with a 2-day history of sudden decreased vision in the right eye. Temporal arteritis was suspected with an elevated erythrocyte sedimentation rate (71 mm/h), and oral prednisolone was started immediately. Four days later, the patient's right eye vision deteriorated from 0.6 to 0.05, with a grade-4 relative afferent pupillary defect and ophthalmoplegia. Computed tomography showed a contrast-enhancing orbital apex mass in the right orbit abutting the medial and lateral portions of the optic nerve with extension to the posterior ethmoid and sphenoid sinuses. A transethmoidal biopsy was performed which yielded septate hyphae suggestive of Aspergillus infection. Ten days later, the patient's right eye vision further deteriorated to hand movement with total ophthalmoplegia. MRI of the orbit showed suspicion of cavernous sinus thrombosis. A combined lateral orbitotomy and transethmoidal orbital apex drainage and decompression were performed to eradicate the orbital apex abscess. Drained pus cultured Aspergillus. The patient was prescribed systemic voriconazole for a total of 22 weeks. The latest MRI scan, performed 8 months after surgery, showed residual inflammatory changes with no signs of recurrence of the disease. To our knowledge, this is the first case report which describes the use of a combined open and endoscopic approach for orbital decompression and drainage in a case of orbital aspergillosis. We believe the combined approach gives good exposure to the orbital apex, and allows the abscess in this region to be adequately drained.

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Orbital aspergillus infection diagnosed by FNAC

Cited by 9 publications

References 9 publications

Defensin Production by Human Limbo-Corneal Fibroblasts Infected with Mycobacteria

Defensin Production by Human Limbo-Corneal Fibroblasts Infected with Mycobacteria

Orbital Complications of Acute Invasive Fungal Rhinosinusitis: A New Challenge in the COVID-19 Convalescent Patients

Combined Lateral Orbitotomy and Endoscopic Transnasal Orbital Decompression in a Case of Orbital Aspergillosis with Impending Intracranial Invasion

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