ABSTRACT NUMBER - 64

AN ATYPICAL CASE OF ORBITAL ASPERGILLOSIS ARISING FROM ISOLATED FRONTAL SINUS DISEASE


Luke Halliday1,2, David Curragh1,2, Dinesh Selva1

Meeting:  2018 RANZCO


SESSION INFORMATION

Date:      -

Session Title: POSTER ABSTRACT- OCULOPLASTIC/ORBIT

Session Time:      -

Purpose: Sino-orbital aspergillosis is an uncommon condition that typically originates from infection of the maxillary, ethmoid or sphenoid sinuses. We report a case of aspergillosis invading the orbit from an isolated focus in the frontal sinus.
Method: A case report and literature review of sino-orbital aspergillosis.
Results: A 78-year-old man presented with painful left upper eyelid swelling of 3 weeks duration. His medical history included ongoing treatment for mul- tiple myeloma and a left-sided forehead squamous cell carcinoma excised 3-years previously. On exam- ination, visual acuity was 6/9 on the left, there was numbness in the distribution of the ophthalmic branch of the left trigeminal nerve and restriction of supraduction, abduction and adduction on the left side. Radiological evaluation found a heterogeneous mass in the left superolateral orbit and mild left- sided frontal sinusitis. An orbital biopsy was per- formed that identified broad fungal hyphae with no evidence of malignancy. The patient was treated with intravenous amphotericin B and subsequently proceeded to exenteration, at which time explora- tion and curettage of the paranasal sinuses demon- strated growth of aspergillus fumigatus from the left frontal sinus.
Conclusion: This case highlights the importance of considering sino-orbital fungal disease in cases of orbital lesions to allow timely identification and management of this rapidly fatal condition.

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