Artikel
Invasive fungal aspergillosis of the skull base and the orbit in immunosuppressed patient: a case report
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Veröffentlicht: | 22. September 2005 |
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Gliederung
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Backround: The aspergillosis of the paranasal sinuses, depending on invasion of the tissue, is subdivided in a non-invasive and an invasive aspergillosis. The invasive type often occurs in immunodeficient patients and can be divided into three forms: granulomatous form, the chronic-invasive form and the acute-fulminating form.
Case report: We report the clinical course of an immunosuppressed male patient with an invasive fungal aspergillosis of the sphenoid sinus and the orbit with intracranial extension into the cavernous sinus. The patient was introduced to our hospital with amaurosis, ptosis and ophthalmoplegia since 3 months. Additional the patient suffered from kidney failure after NTX and diabetes mellitus II. The patient was undertaken a endonasal sinus debridement and decompression of the orbit after CT-scans and a systemical antibiotic-therapy. Furthermore, a systemical and local antimycotic therapy was performed. As according to the recommendations of the “Undersea and hyperbaric Medicine Society” a cerebral abscess is a certain indication for hyperbaric oxygenation we decided in this situation to attempt this therapy additional.The patient died within 3 weeks of surgical intervention due to carotid dissection.
Conclusion: The acute-invasive sinus aspergillosis of immunsuppressed patients is usually lethal because of intracranial complications. Therefore a fast diagnosis including CT and MRI-scans, surgical and antimycotic therapy are necessary.