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Tanon AK, Assouan C, Anzouan-Kacou E, N'guessan D, Salami A, Boni S, Konan E. [Pseudo-tumoral invasive fungus infection of the maxillary sinus in Abidjan]. J Mycol Med 2017; 27:285-289. [PMID: 28336168 DOI: 10.1016/j.mycmed.2017.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The invasive fungal infection of the maxillary sinus is a rare and serious disease generally favored by immunosuppression. We report an exceptional case of pseudotumoral invasive fungal infection of the maxillary sinus in an immunocompetent patient. OBSERVATION A 32-year-old patient consulted for labial and left temporal swelling associated with proptosis and chemosis that has been developing for 18 months. The scanner objectified a filling of the left maxillary sinus, and the ipsilateral orbital cavity, and the surrounding muscles. Histological examination of the surgical specimen revealed invasive fungal infection of the left maxillary sinus. The relevant antifungal therapy, namely voriconazole, could not be administered due to the unavailability of the medicine. However, the patient has received 200mg of itraconazole every 12hours for three weeks. The change proved disappointing with recurrence and significant sequelae, sort of sagging of the right hemifacial, severe limitation of mouth opening and functional loss of the right eye. CONCLUSION The invasive fungus infections of the maxillary sinus and the orbit are exceptional in immunocompetent patient. Healing is based on early diagnosis and administration of the reference antifungal to face the risk of recurrence.
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Affiliation(s)
- A K Tanon
- Service des maladies infectieuses et tropicales, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - C Assouan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Anzouan-Kacou
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - D N'guessan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - A Salami
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire.
| | - S Boni
- Service d'ophtalmologie, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
| | - E Konan
- Service de stomatologie et chirurgie maxilllo-faciale, CHU de Treichville, BP V3, Abidjan, Côte d'Ivoire; Unité de formation et de recherche en sciences médicales, université Félix-Houphouet, Boigny de Cococdy, Abidjan, Côte d'Ivoire.
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Leyngold I, Olivi A, Ishii M, Blitz A, Burger P, Subramanian PS, Gallia G. Acute chiasmal abscess resulting from perineural extension of invasive sino-orbital aspergillosis in an immunocompetent patient. World Neurosurg 2013; 81:203.e1-6. [PMID: 23973515 DOI: 10.1016/j.wneu.2013.08.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 05/30/2013] [Accepted: 08/14/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Intracranially invasive sino-orbital aspergillosis is a rare entity seen predominantly in immunocompromised individuals. We report a unique case of an acute chiasmal abscess resulting from perineural extension of an indolent invasive sino-orbital aspergillosis in an immunocompetent patient. CASE DESCRIPTION A 61-year-old healthy Ukrainian man presented with severe left retro-orbital pain and a gradual ipsilateral monocular vision loss with rapid progression to a contralateral temporal visual field cut. He was found to have an intracranially invasive sino-orbital Aspergillus fumigatus infection with perineural extension along the optic nerve complicated by an acute chiasmal abscess. RESULTS The patient was managed with surgical debridement and adjuvant antifungal chemotherapy. The patient's life and vision were preserved. CONCLUSIONS The case demonstrates that it is possible to successfully control advanced intracranial aspergillosis with tissue-sparing surgery and adjuvant antifungal chemotherapy in immunocompetent individuals.
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Affiliation(s)
- Ilya Leyngold
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Alessandro Olivi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ari Blitz
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Peter Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Prem S Subramanian
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gary Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abir B, Abouchadi A, Hamama J, Oukabli M, Nassih M, Rzin A. [Invasive aspergillosis of the maxillary sinus in an immunocompetent patient]. ACTA ACUST UNITED AC 2012; 113:127-30. [PMID: 22285744 DOI: 10.1016/j.stomax.2011.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2010] [Revised: 06/06/2011] [Accepted: 12/23/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Invasive aspergillosis of the maxillary sinus is a severe infection most commonly observed in immunocompromised patients. We report a pseudo-tumoral presentation of invasive aspergillosis of the maxillary sinus, in immunocompetent adult. CASE REPORT A 70-year-old female patient consulted for chronic rhino-sinusitis resistant to medical treatment. Computed tomography scan revealed a hyperdense mass filling the left maxillary antrum, with erosion of sinus walls. The ethmoidal and right frontal sinuses were involved. The histological and mycological examination of the surgical resection confirmed the diagnosis of invasive aspergillosis. The patient was given voriconazole as first line treatment. The outcome was good at 18 months. DISCUSSION Invasive aspergillosis of the maxillary sinus is a rare disease, usually observed in immunodepressed patients. It is very rarely observed in immunocompetent patients.
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Affiliation(s)
- B Abir
- Service de chirurgie plastique et stomatologie, hôpital militaire d'instruction Mohamed-V, Rabat, Maroc.
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Zainine R, Hachicha A, Gamra S, Beltaief N, Sahtout S, Besbes G. Aspergillose sphénoïdale chez deux patients immunocompétents. J Mycol Med 2011. [DOI: 10.1016/j.mycmed.2011.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cerebral Vasculitis Caused by Aspergillus Simulating Ischemic Stroke in an Immunocompetent Patient. J Emerg Med 2010; 38:597-600. [DOI: 10.1016/j.jemermed.2007.09.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 09/14/2007] [Accepted: 09/16/2007] [Indexed: 11/17/2022]
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