scholarly journals Atypical Optic Neuritis in an Immunocompetent Patient with Orbital

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Nurul 'Ain Masnon ◽  
Wan Hazabbah Wan Hitam ◽  
Lakana Kumar Thavaratnam ◽  
Maimunah Abd Munaaim
Keyword(s):  
Visual Acuity ◽  
Cavernous Sinus ◽  
Sphenoid Sinus ◽  
Immunocompetent Patient ◽  
Endoscopic Biopsy ◽  
Orbital Apex ◽  
Aspergillus Infection ◽  
Long Duration ◽  
Orbital Space ◽  
Immunocompetent Patients

Aspergillosis infection in immunocompetent individuals is an uncommon entity. Non-specific presentation could delay in the diagnosis and management. We describe a case of orbital aspergillosis with cavernous sinus extension in a healthy lady. A 67-year-old lady presented with left eye decreased vision, preceded by non-specific headache for three weeks. Visual acuity deteriorated followed by ptosis and left ocular restrictions after corticosteroids therapy. Examination revealed poor left eye visual acuity with ptosis, anisocoria and total ophthalmoplegia. MRI orbit and brain demonstrated a heterogenous left orbital apex lesion extending to cavernous sinus. Transsphenoidal endoscopic biopsy revealed Aspergillus infection at the left retro-orbital space and the sphenoid sinus. Patient was treated with long duration of oral voriconazole. Ptosis and ophthalmoplegia resolved but left optic atrophy remained. In conclusion, orbital aspergillosis may carry a poor visual prognosis and intracranial spread does easily occur. Early treatment may lead to a better outcome in immunocompetent patients.

Combined external and endoscopic transnasal approach with use of a diamond burr in the removal of a fishing harpoon hook traversing bilateral sphenoid sinuses in a 22-year-old man

2021 ◽  
Vol 14 (5) ◽  
pp. e239055
Author(s):  
Jan Alexeis Lacuata ◽  
Agnes Tirona - Remulla ◽  
Arsenio Claro Cabungcal ◽  
Romiena Mae Santos
Keyword(s):  
Visual Acuity ◽  
Sphenoid Sinus ◽  
Oral Antibiotics ◽  
Orbital Apex ◽  
Transnasal Approach ◽  
Endoscopic Transnasal Approach ◽  
Diamond Burr ◽  
The Right ◽  
Sphenoid Sinuses

A 22-year old construction worker was shot with a fishing harpoon gun on the left side of his face. He consulted at the emergency room 12 days postinjury, stable but with blurring of vision on the right. The shaft of the harpoon was protruding at the left preauricular area; the tip was neither visible nor palpable. Craniofacial CT scan and skull anteroposterolateral radiographs revealed the tip of the harpoon to be at the right orbital apex. A hook attached 1 cm from the tip was lodged in the sphenoid sinus. The hook was dismantled from the shaft via a combined external and endoscopic transnasal approach, enabling the shaft to be gently pulled. The hook, together with the tip, were removed endoscopically. The patient’s visual acuity improved. He was discharged after 2 days on oral antibiotics with no deficits on follow-up.

scholarly journals Invasive fungal disease misdiagnosed as tumour in association with orbital apex syndrome

2021 ◽  
Vol 14 (1) ◽  
pp. e237626
Author(s):  
Sucheta Parija ◽  
Aparajita Banerjee
Keyword(s):  
Vision Loss ◽  
Invasive Fungal Disease ◽  
Endoscopic Biopsy ◽  
Review Of Literature ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Gadolinium Contrast ◽  
Progressive Loss ◽  
The Right ◽  
Immunocompetent Patients

Invasive sino-orbital aspergillosis is a rare cause of orbital apex syndrome (OAS) in immunocompetent patients and often misdiagnosed as tumour because of its aggressive nature and invasive patterns. We report a 23-year-old immunocompetent man presenting with painful progressive loss of vision, ophthalmoplegia and proptosis of the right eye suggestive of OAS. MRI with gadolinium contrast showed an enhancing heterogeneous mass filling the paranasal sinuses, extraconal space and extending up to the right orbital apex. A functional endoscopic biopsy reported as invasive sino-orbital aspergillosis. He was started on intravenous voriconazole and maximal surgical debridement was done. He gradually regained his vision to 20/30 in the right eye. A review of literature reported several such cases which were managed medically or surgically but with poor visual recovery. This case highlights the need for awareness among clinicians for early diagnosis and treatment to prevent vision loss and better survival.

scholarly journals An unusual case of complicated rhinosinusitis of the sphenoid sinus involving the cavernous sinus and skull base: Endoscopic sinus surgery and medical therapy

2019 ◽  
Vol 7 ◽  
pp. 2050313X1985288 ◽  
Author(s):  
Gian Luca Fadda ◽  
Anna D’Eramo ◽  
Dario Gned ◽  
Giovanni Succo ◽  
Andrea Galizia ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Sphenoid Sinus ◽  
Unusual Case ◽  
Immunocompetent Patient ◽  
Sinus Surgery ◽  
Direct Access ◽  
Resonance Imaging ◽  
Sinus Disease ◽  
Threatening Condition ◽  
Life Threatening

Isolated sphenoid sinus diseases are generally asymptomatic and relatively uncommon with the potential for serious complications. Patients with this condition should be monitored closely and treated aggressively and either diagnostic or therapeutic intent is often indicated. In the management of a complex, life-threatening condition that involves many different fields of expertise, the otolaryngologist plays a key role in orchestrating different specialists and gaining direct access to the affected area, thus taking the first and essential step towards diagnosis and therapy. Because of the superiority of computed tomography in defining the bony margins and the superior soft tissue resolution of magnetic resonance imaging, these two techniques should be used in a complementary manner in the evaluation of isolated sphenoid sinus disease in addition to mapping the lesion better and identifying intracranial and intraorbital extent. We report an unusual case of isolated rhinosinusitis of the sphenoid sinus involving the cavernous sinus, pterygoid fossae and masticatory space in an immunocompetent patient.

scholarly journals A case of orbital apex syndrome due to aspergillus infection that avoided loss of visual acuity by optic canal decompression

2016 ◽  
Vol 56 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Kenji Yoshida ◽  
Akiko Shirata ◽  
Taku Sato ◽  
Yugo Kishida ◽  
Kiyoshi Saito ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Canal ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Aspergillus Infection ◽  
Loss Of Visual Acuity

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

scholarly journals Orbital Apex Syndrome due to Invasive Aspergillosis in an Immunocompetent Patient

IDCases ◽  
2021 ◽  
pp. e01232
Author(s):  
Grace D. Cullen ◽  
Tara M. Davidson ◽  
Zachary Yetmar ◽  
Bobbi S. Pritt ◽  
Daniel C. DeSimone
Keyword(s):  
Invasive Aspergillosis ◽  
Immunocompetent Patient ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

scholarly journals Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon

2010 ◽  
Vol 52 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Juan Nunura ◽  
Tania Vásquez ◽  
Sergio Endo ◽  
Daniela Salazar ◽  
Alejandrina Rodriguez ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Muscle Biopsy ◽  
Blood Smear ◽  
Immunocompetent Patient ◽  
Peruvian Amazon ◽  
Thick Blood Smear ◽  
First Case ◽  
Hip Extension

We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.

scholarly journals Prostatic tuberculosis: case report

2008 ◽  
Vol 126 (4) ◽  
pp. 227-228 ◽  
Author(s):  
Daniel Sáenz-Abad ◽  
Santiago Letona-Carbajo ◽  
José Luis de Benito-Arévalo ◽  
Isabel Sanioaquín-Conde ◽  
Francisco José Ruiz-Ruiz
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Urine Culture ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Tuberculosis Case ◽  
Immunocompetent Patients

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

Hemangiopericytoma of the Sphenoid Sinus

1981 ◽  
Vol 89 (5) ◽  
pp. 713-716 ◽  
Author(s):  
Charles P. Kimmelman
Keyword(s):  
Radiation Therapy ◽  
Sphenoid Sinus ◽  
Vascular Tumor ◽  
External Beam Radiation ◽  
Orbital Apex ◽  
Tumor Nodule ◽  
Beam Radiation ◽  
The Right ◽  
Sinus Ostium ◽  
Ethmoid Labyrinth

A 51-year-old woman complained of intermittent nasal obstruction and rhinorrhea. Sinus roentgenograms and polytomograms revealed a small mucocele of the right sphenoid sinus. There was no encroachment of the orbital apex or intracranial contents. The mucocele was marsupialized via an external ethmoidectomy, and the scant tissue present inside the sinus was examined histologically. The pathologic diagnosis was hemangiopericytoma. The small tumor had apparently originated at the sinus ostium, thus creating the mucocele. Several months postoperatively, a small, vascular tumor nodule was noted in the incision. No recurrence was evident intranasally. A course of 5,040 rads of external beam radiation therapy was given to the right ethmoid labyrinth and right sphenoid. Since completing her radiation therapy, there has been no recurrence. This case is of interest because the tumor occurred as a mucocele of the sphenoid sinus.

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