Invasive oral and nasal aspergillosis in an immunocompetent child

Paiva, Soliel Shandy Costa; Siqueira, Ana Paula Viana de; Costa, Lusmaia Damaceno Camargo; Godinho, Teresa Cristina Saddi; Fortes, Patrícia Marques; Costa, Paulo Sucasas

doi:10.1016/s1473-3099(19)30698-x

Cited by 2 publications

(2 citation statements)

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“…There were no obvious identified risk factors for the development of invasive fungal RS as the patient did not have immunodeficiency or disease such as diabetes mellitus [ 25 ] or haematological malignancy [ 18 ]. These findings are consistent with the previously reported cases of invasive rhino-orbital-cerebral aspergillosis and invasive oronasal aspergillosis in immunocompetent patients [ 19 , 21 , 22 , 23 ].…”

Section: Discussion and Literature Reviewsupporting

confidence: 93%

Sinonasal Orbital Apex Syndrome, Horner Syndrome and Pterygopalatine Fossa Infection: A Case Report and Mini-Review

Benites,

Urbančič,

Bardales

et al. 2023

Life

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This paper presents a literature review and a case of an 83-year-old otherwise healthy female patient with a history of recent syncope, a sudden-onset right-sided temporal headache, diplopia, and vision loss. An exam revealed right-sided upper eyelid ptosis, myosis, vision loss, ophthalmoplegia, and a positive relative afferent pupillary defect on the right eye. CT showed sphenoid sinus opacification, eroded lateral sinus wall, Vidian canal, disease extension to the posterior ethmoid air cells, orbital apex, medial orbital wall, and pterygopalatine fossa. An orbital apex syndrome (Jacod’s syndrome), Horner syndrome, and pterygopalatine fossa infection were diagnosed due to the acute invasive fungal sinusitis developed from a sphenoid sinus fungal ball. The patient was treated with antimicrobial therapy and transnasal endoscopic surgery twice to decompress the orbital apex, drain the abscess and obtain specimens for analysis. The right-sided ptosis, visual loss, ophthalmoplegia, and headache resolved entirely. No immune or comorbid diseases were identified, microbiological and histopathological analyses were negative, and MRI could not be performed on the presented patient. For that reason, the diagnostic procedure was non-standard. Nevertheless, the treatment outcome of this vision and life-threatening disease was satisfactory. Treating the fungal ball in an older or immunocompromised patient is essential to prevent invasive fungal rhinosinusitis and fatal complications.

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Section: Discussion and Literature Reviewsupporting

confidence: 93%

Sinonasal Orbital Apex Syndrome, Horner Syndrome and Pterygopalatine Fossa Infection: A Case Report and Mini-Review

Benites,

Urbančič,

Bardales

et al. 2023

Life

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“…Aspergillus has predominantly been reported in immunocompromised children 14 15. However, there have been a few case reports of aspergillosis in immunocompetent patients also 16 17. The incidence may have increased in the postCOVID era,18 may be due to inadvertent use of steroids.…”

Section: Discussionmentioning

confidence: 99%

Sentinel ear bleed as a presenting sign for carotid artery blowout due to aspergillus abscess in parapharyngeal space in an immunocompetent infant

Rajpal,

Saxena,

Meher

et al. 2024

BMJ Case Rep

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Parapharyngeal abscesses leading to complications, although rare after the advent of antibiotics, can lead to serious complications. One such complication is carotid erosion that can lead to a potentially fatal carotid artery blowout. We report a case of a previously healthy infant who presented with fever, ear bleed and progressively increasing swelling in the right side of his neck that led to airway compromise. The child required immediate securing of the airway at presentation. Imaging revealed lobulated abscess with multiple bleeding points eroding the carotid vessels, along with internal jugular venous thrombus. Surgical exploration was done and abscess debulked. Histopathology revealed aspergillus, which was treated with antifungals. He was discharged on oral warfarin after 40 days of hospital stay and remains well on follow-up. Sentinel ear bleed warrants close observation for possibility of carotid artery blowout in children with parapharyngeal abscesses.

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Invasive oral and nasal aspergillosis in an immunocompetent child

Cited by 2 publications

References 0 publications

Sinonasal Orbital Apex Syndrome, Horner Syndrome and Pterygopalatine Fossa Infection: A Case Report and Mini-Review

Sinonasal Orbital Apex Syndrome, Horner Syndrome and Pterygopalatine Fossa Infection: A Case Report and Mini-Review

Sentinel ear bleed as a presenting sign for carotid artery blowout due to aspergillus abscess in parapharyngeal space in an immunocompetent infant

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