A Case of Invasive Sphenoid Sinus Aspergillosis Presenting as Oculomotor Nerve Palsy in a Healthy Patient

• FUJIMOTO Takashi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• MOROFUJI Yoichi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• HIU Takeshi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• YOSHIDA Koichi

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• IZUMIKAWA Koichi

  Department of Infectious Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• WATANABE Takeshi

  Department of Otolaryngology – Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

• MATSUO Takayuki

  Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan

Abstract

Invasive sphenoid sinus aspergillosis is a rare infection and usually affecting immunocompromised patients. We describe an invasive sphenoid sinus aspergillosis patient with immunocompetent who present progressive ocular dysfunctions. A 66-year-old woman with no history of immune dysfunction was referred to our hospital with orbital complications. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass lesion extending from the left orbital apex to the sphenoid sinus. Inflammatory diseases were not suspected by laboratory findings, but a transnasal endoscopic biopsy revealed sphenoid sinus aspergillosis. After treatment of antifungal medication, this patient showed improvement and no sign of recurrence during the follow-up period. Diagnosis of invasive sphenoid sinus aspergillosis in an immunocompetent, healthy individual, was challenging. However, if patients have sinus wall deformities and orbital complications, early surgery is necessary to improve their prognosis.

Journal

• NMC Case Report Journal

  NMC Case Report Journal 8 (1), 343-347, 2021

  The Japan Neurosurgical Society

Keywords

• sphenoid sinus aspergillosis
• immunocompetent patient
• endoscopic biopsy

Details

• CRID: 1390006982830526720
• NII Article ID: 130008055891
• DOI: 10.2176/nmccrj.cr.2020-0189
• ISSN: 21884226
• Web Site: https://www.jstage.jst.go.jp/article/nmccrj/8/1/8_cr.2020-0189/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022122765
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed