Annals of the Academy of Medicine, Singapore · 2008
Fungal pan-sinusitis with severe visual loss in uncontrolled diabetes.
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Chua Jocelyn L L, Cullen James F
Аннотация
INTRODUCTION: Invasive 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 PICTURE: Respective clinical presentations of orbital apex and cavernous sinus syndromes were associated with isolation of Aspergillus galactomannan and Rhizopus.
TREATMENT: Urgent extensive surgical debridement and systemic antifungal is necessary.
OUTCOME: Clinical improvement of the ocular motor nerves can be expected within 2 months of treatment but visual loss is usually permanent.
CONCLUSION: Underlying pansinusitis is an important differential for acute visual loss, especially in uncontrolled diabetics. Early treatment determines outcome.
CLINICAL PICTURE: Respective clinical presentations of orbital apex and cavernous sinus syndromes were associated with isolation of Aspergillus galactomannan and Rhizopus.
TREATMENT: Urgent extensive surgical debridement and systemic antifungal is necessary.
OUTCOME: Clinical improvement of the ocular motor nerves can be expected within 2 months of treatment but visual loss is usually permanent.
CONCLUSION: Underlying pansinusitis is an important differential for acute visual loss, especially in uncontrolled diabetics. Early treatment determines outcome.