Frontal Sinus Infection Leading to Sino-orbital Aspergillosis: a Case Report

Overview

Journal Pan Afr Med J

Date 2021 Dec 15

PMID 34909083

Authors

Camille Yvon

Didar Abdulla

Sarah Watson

Izhar Bagwan

Christopher McLean

Affiliations

Soon will be listed here.

Abstract

Sino-orbital aspergillosis is an uncommon but aggressive infection. It rarely originates from the frontal sinus due to the complex anatomy of the frontal recess and anteromedial position of its ostium. An 87-year-old man of Nigerian heritage with a history of multiple myeloma, chronic kidney disease and type 2 diabetes, presented to the eye clinic with a right tense swollen eyelid and proptosis. Computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed a right superomedial mass communicating with the frontal sinus and biopsy confirmed an orbital aspergilloma. The patient was successfully treated with debulking surgery and anti-fungal treatment despite developing side effects to the drugs. To improve prognosis, ophthalmologists should be aware of this distinct entity and use a multi-disciplinary approach.

References

Chang Y, Chang Y, Chien K, Liang C, Tai M, Nieh S . Orbital apex syndrome secondary to aspergilloma masquerading as a paranasal sinus tumor: A case report and literature review. Medicine (Baltimore). 2018; 97(30):e11650. PMC: 6078660. DOI: 10.1097/MD.0000000000011650. View

Gupta R, Gupta A . Isolated primary frontal sinus aspergillosis: role of endonasal endoscopic approach. J Laryngol Otol. 2013; 127(3):274-8. DOI: 10.1017/S0022215112003179. View

Alaraj A, Al-Faky Y, Alsuhaibani A . Ophthalmic Manifestations of Allergic Fungal Sinusitis. Ophthalmic Plast Reconstr Surg. 2018; 34(5):463-466. DOI: 10.1097/IOP.0000000000001051. View

Nishiike S, Yoda S, Shikina T, Murata J . Endoscopic Transseptal Approach to Frontal Sinus Disease. Indian J Otolaryngol Head Neck Surg. 2015; 67(3):287-91. PMC: 4575666. DOI: 10.1007/s12070-015-0879-7. View

Dufour X, Kauffmann-Lacroix C, Ferrie J, Goujon J, Rodier M, Karkas A . Paranasal sinus fungus ball and surgery: a review of 175 cases. Rhinology. 2005; 43(1):34-9. View

Swoboda H, Ullrich R . Aspergilloma in the frontal sinus expanding into the orbit. J Clin Pathol. 1992; 45(7):629-30. PMC: 495196. DOI: 10.1136/jcp.45.7.629. View

Halliday L, Curragh D, Selva D . A rare case of invasive sino-orbital aspergillosis arising from isolated frontal sinus infection. Can J Ophthalmol. 2019; 54(1):e19-e21. DOI: 10.1016/j.jcjo.2018.04.022. View

Adulkar N, Radhakrishnan S, Vidhya N, Kim U . Invasive sino-orbital fungal infections in immunocompetent patients: a clinico-pathological study. Eye (Lond). 2019; 33(6):988-994. PMC: 6707179. DOI: 10.1038/s41433-019-0358-6. View

Levin L, Avery R, Shore J, Woog J, Baker A . The spectrum of orbital aspergillosis: a clinicopathological review. Surv Ophthalmol. 1996; 41(2):142-54. DOI: 10.1016/s0039-6257(96)80004-x. View

10.

Suzuki K, Iwabuchi N, Kuramochi S, Nakanoma J, Suzuki Y, Serizawa H . Aspergillus aneurysm of the middle cerebral artery causing a fatal subarachnoid hemorrhage. Intern Med. 1995; 34(6):550-3. DOI: 10.2169/internalmedicine.34.550. View

11.

Colon-Acevedo B, Kumar J, Richard M, Woodward J . The Role of Adjunctive Therapies in the Management of Invasive Sino-Orbital Infection. Ophthalmic Plast Reconstr Surg. 2015; 31(5):401-5. DOI: 10.1097/IOP.0000000000000488. View