scholarly journals Covid associated orbital apex syndrome: Madras ENT Research Foundation experience

2021 ◽  
Vol 7 (9) ◽  
pp. 1513
Author(s):  
Manjunatha H. Anandappa ◽  
Sunil Mathews ◽  
Kiran Natarajan ◽  
Raghunandhan S. ◽  
Mohan Kameswaran
Keyword(s):  
Elderly Patients ◽  
Relevant Literature ◽  
Case Series ◽  
Healthy Individuals ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Timely Manner ◽  
Management Protocol ◽  
Life Threatening ◽  
Second Wave

<p class="abstract">The second wave of corona virus pandemic is currently raging through India since last few weeks. Since last year, COVID-19 has brought in a multitude of challenging manifestations in the ENT regions. One such rare and complex entity is OAS (orbital apex syndrome). This case series highlighted our experience in 2020 with managing two such cases of OAS associated with COVID-19 infection. Their clinical and radiological presentation was discussed and their management protocol was explained with references from relevant literature. Although elderly patients with co-morbidities were considered to have highest risk for COVID-19 associated neurologic and ophthalmic complications earlier, now it was found to affect younger healthy individuals as noted in our cases. Knowledge about such virulent complications of COVID-19 is essential for otolaryngologists, to manage this life-threatening entity in a timely manner.</p>

scholarly journals Orbital apex syndrome affecting head and neck cancer patients: A case series

2017 ◽  
pp. 0-0
Author(s):  
AC Prado-Ribeiro ◽  
AC Luiz ◽  
MA. Montezuma ◽  
MP Mak ◽  
AR Santos-Silva ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Case Series ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

Orbital Apex Syndrome: A Case Series and Review of the Literature

2014 ◽  
Vol 72 (9) ◽  
pp. e27-e28
Author(s):  
R.E. Warburton ◽  
C. C. Dicus Brookes ◽  
T.A. Turvey
Keyword(s):  
Case Series ◽  
Review Of The Literature ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

scholarly journals Orbital Aspergillosis Mimicking Giant Cell Arteritis

2021 ◽  
Vol 16 (1) ◽  
pp. 262-270
Author(s):  
Mae-Lynn Catherine Bastion ◽  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Neuropathy ◽  
Elderly Person ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Asian Populations ◽  
Intravenous Corticosteroid ◽  
Threatening Condition ◽  
Life Threatening

Orbital aspergillosis is a very rare, debilitating disease which can present solely with painful optic neuropathy and mimic giant cell arteritis in an elderly person. We report a case of orbital aspergillosis in a 65-year-old Malay man who presented with unilateral gradual blurring of vision and ipsilateral headache. Our initial working diagnosis was giant cell arteritis. Unfortunately, patient’s condition worsened with intravenous corticosteroid and developed into orbital apex syndrome. Imaging and biopsy results showed evidence of orbital aspergillosis. Patient lost his eyesight due to the wrong initial working diagnosis. This report is to emphasize that although giant cell arteritis is also a sight and life-threatening condition, it is rare among Asian populations. We need to take into account the epidemiology of the disease and look into any other differential diagnoses when the presentation is atypical.

scholarly journals An unusual presentation of sphenoid Candida fungal ball: a case report

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Geng Ju Tuang ◽  
Farah Dayana Zahedi ◽  
Izzah Akashah ◽  
Jennifer Peak Hui Lee ◽  
Zainal Azmi Zainal Abidin
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Immune Status ◽  
Immunocompetent Patient ◽  
Unusual Presentation ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Fungal Ball ◽  
Life Threatening

Abstract The clinical presentation of a sphenoid fungal ball (FB) is often non-specific and tends to be overlooked, particularly in hosts with an intact immune status. Rarely, potentially life-threatening complications may arise, owning its anatomical characteristics with contiguous structures. Herein, we present an unusual case of sphenoid FB complicated with orbital apex syndrome in an immunocompetent patient. The diagnosis dilemma and subsequent management are further discussed.

scholarly journals Rhino-orbital mucormycosis related to COVID-19- A case series exploring risk factors

2021 ◽  
Author(s):  
Sushil Kumar Aggarwal ◽  
Upinder Kaur ◽  
Dolly Talda ◽  
Akshat Pandey ◽  
Sumit Jaiswal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Mechanisms ◽  
Common Factor ◽  
Case Series ◽  
Intracranial Extension ◽  
Management Protocol ◽  
Male Preponderance ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Second Wave

Abstract There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycaemia due to diabetes present as a common comorbidity in these COVID-19 patients as well as indiscriminate steroid use has resulted in this surge. Here, we report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted at our center between mid-April and early June 2021. Out of the 13, the only common factor was COVID-19 at some time point before diagnosis of mucormycosis or coexistent with it. The cases showed a male preponderance and four of them showed intracranial extension of disease. Eleven of them had received steroids as part of COVID-19 management protocol and twelve of them had pre-existing or newly diagnosed diabetes. We have summarized other probable risk factors being considered such as immunosuppressed state, antiviral and Ayurvedic (Indian traditional) medications, oxygen therapy, with each of which we could not find a link of mucormycosis. We propose that COVID-19 itself through molecular mechanisms predisposes to mucormycosis, with other factors such as dysglycaemia providing a second hit.

scholarly journals Timely Diagnosis of Pneumoperitoneum by Point-of-care Ultrasound in the Emergency Department: A Case Series

2021 ◽  
Vol 5 (4) ◽  
pp. 377-380
Author(s):  
Jung Yum ◽  
Taryn Hoffman ◽  
Leily Naraghi
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Elderly Patients ◽  
Point Of Care ◽  
Case Series ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Hollow Viscus ◽  
Timely Diagnosis ◽  
Life Threatening

Introduction: Pneumoperitoneum is a life-threatening diagnosis that requires timely diagnosis and action. We present a case series of patients with perforated hollow viscus who were accurately diagnosed by emergency physicians using point-of-care ultrasound (POCUS) while in the emergency department (ED). Case Series: Three elderly patients presented to the ED with the complaints of syncope, abdominal pain with constipation, and unresponsiveness. The emergency physicians used POCUS to diagnose and then expedite the necessary treatment. Conclusion: Point-of-care ultrasound can be used by emergency physicians to diagnose pneumoperitoneum in the ED.

Frozen overnight: Acute orbital apex syndrome caused by aspergillosis

2022 ◽  
pp. 112067212110734
Author(s):  
Francesco Pellegrini ◽  
Erika Mandarà ◽  
Altin Stafa ◽  
Salvatore Meli
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Retrospective Case ◽  
Acute Presentation ◽  
Hunt Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Language Literature

Purpose to describe a rare case of orbital apex syndrome caused by aspergillosis with acute presentation. Case description retrospective case report of a 70-year-old man who developed unilateral ophthalmoplegia overnight. He was initially given the diagnosis of suspect Tolosa-Hunt syndrome, but biopsy of the involved tissue showed aspergillosis. Conclusion orbital apex syndrome caused by fungal disease is a life-threatening condition that should be promptly diagnosed and treated. It may present acutely and should not be misdiagnosed as Tolosa-Hunt syndrome. To our knowledge this is the first such case report in the English ophthalmic language Literature.

scholarly journals Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19

2020 ◽  
Vol 12 (570) ◽  
pp. eabd3876 ◽  
Author(s):  
Yu Zuo ◽  
Shanea K. Estes ◽  
Ramadan A. Ali ◽  
Alex A. Gandhi ◽  
Srilakshmi Yalavarthi ◽  
...  
Keyword(s):  
Antiphospholipid Syndrome ◽  
Estimated Glomerular Filtration Rate ◽  
Case Series ◽  
Healthy Individuals ◽  
Serum Samples ◽  
Extracellular Traps ◽  
Glycoprotein I ◽  
Lung Histopathology ◽  
Life Threatening ◽  
Net Release

Patients with COVID-19 are at high risk for thrombotic arterial and venous occlusions. Lung histopathology often reveals fibrin-based blockages in the small blood vessels of patients who succumb to the disease. Antiphospholipid syndrome is an acquired and potentially life-threatening thrombophilia in which patients develop pathogenic autoantibodies targeting phospholipids and phospholipid-binding proteins (aPL antibodies). Case series have recently detected aPL antibodies in patients with COVID-19. Here, we measured eight types of aPL antibodies in serum samples from 172 patients hospitalized with COVID-19. These aPL antibodies included anticardiolipin IgG, IgM, and IgA; anti–β2 glycoprotein I IgG, IgM, and IgA; and anti-phosphatidylserine/prothrombin (aPS/PT) IgG and IgM. We detected aPS/PT IgG in 24% of serum samples, anticardiolipin IgM in 23% of samples, and aPS/PT IgM in 18% of samples. Antiphospholipid autoantibodies were present in 52% of serum samples using the manufacturer’s threshold and in 30% using a more stringent cutoff (≥40 ELISA-specific units). Higher titers of aPL antibodies were associated with neutrophil hyperactivity, including the release of neutrophil extracellular traps (NETs), higher platelet counts, more severe respiratory disease, and lower clinical estimated glomerular filtration rate. Similar to IgG from patients with antiphospholipid syndrome, IgG fractions isolated from patients with COVID-19 promoted NET release from neutrophils isolated from healthy individuals. Furthermore, injection of IgG purified from COVID-19 patient serum into mice accelerated venous thrombosis in two mouse models. These findings suggest that half of patients hospitalized with COVID-19 become at least transiently positive for aPL antibodies and that these autoantibodies are potentially pathogenic.

scholarly journals Rhino-orbital mucormycosis related to COVID-19- A case series exploring risk factors

2021 ◽  
Author(s):  
Sushil Kumar Aggarwal ◽  
Upinder Kaur ◽  
Dolly Talda ◽  
Akshat Pandey ◽  
Sumit Jaiswal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Molecular Mechanisms ◽  
Common Factor ◽  
Case Series ◽  
Intracranial Extension ◽  
Management Protocol ◽  
Male Preponderance ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Second Wave

Abstract There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycaemia due to diabetes present as a common comorbidity in these COVID-19 patients as well as indiscriminate steroid use has resulted in this surge. Here, we report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted at our center between mid-April and early June 2021. Out of the 13, the only common factor was COVID-19 at some time point before diagnosis of mucormycosis or coexistent with it. The cases showed a male preponderance and four of them showed intracranial extension of disease. Eleven of them had received steroids as part of COVID-19 management protocol and twelve of them had pre-existing or newly diagnosed diabetes. We have summarized other probable risk factors being considered such as immunosuppressed state, antiviral and Ayurvedic (Indian traditional) medications, oxygen therapy, with each of which we could not find a link of mucormycosis. We propose that COVID-19 itself through molecular mechanisms predisposes to mucormycosis, with other factors such as dysglycaemia providing a second hit.

scholarly journals A case series of post COVID-19 mucormycosis—a neurological prospective

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Tamer Roushdy ◽  
Eman Hamid
Keyword(s):  
Sinus Thrombosis ◽  
Case Series ◽  
Tertiary Hospital ◽  
Delayed Presentation ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Current Case ◽  
Case Presentation ◽  
First Case ◽  
Uncontrolled Diabetes

Abstract Background Direct neurological manifestations of coronavirus disease whether peripheral or central are reported worldwide. Yet, along the 3rd wave of the pandemic especially in India, an associated angioinvasive opportunistic infection with mucormycosis in COVID-19 cases is emerging. Case presentation The current case series which represents 4 patients with mucormycosis post COVID-19 is one of a few if not the first case series that discusses post COVID-19 mucormycosis from a neurological prospective in a tertiary hospital in Egypt. All cases but one presented with total ophthalmoplegia, and only one was diagnosed as a cavernous sinus thrombosis; meanwhile, orbital cellulitis and orbital apex syndrome were responsible of ophthalmoplegia in two cases. Mortality reached 25%, and the case that died suffered cutaneous as well as rhino-cerebral type with a delayed presentation to hospital. Conclusion A rare but fatal fungal infection is ought to be nowadays kept in mind in COVID-19 active cases as well as in recovered COVID-19 patients, especially those who have comorbid medical conditions as uncontrolled diabetes and who were treated with large doses of corticosteroids.

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