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Aspergillosis related to long-term nasal corticosteroid use

Robert L Bratton1, Paul W Brazis, Walter C Hellinger

  • 1Department of Family Medicine, Mayo Clinic, Jacksonville, Fla 32224, USA.

Mayo Clinic Proceedings
|December 14, 2002
PubMed

Insights

Invasive aspergillosis, a fungal infection, can occur in non-immunocompromised individuals. This case highlights paranasal sinus aspergillosis in an elderly woman, potentially linked to nasal corticosteroid use.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Aspergillus is a common mold causing various infections like allergic aspergillosis, aspergillomas, and invasive aspergillosis.
  • Invasive aspergillosis typically affects immunocompromised or debilitated patients.

Observation:

  • A case of invasive aspergillosis in the paranasal sinus of an 85-year-old woman is presented.
  • The patient was not immunocompromised but experienced unilateral headache and retrobulbar optic neuropathy.

Findings:

  • Extensive diagnostics suggested a possible link between long-term nasal corticosteroid use (fluticasone propionate) and the invasive fungal infection.
  • Surgical removal of Aspergillus masses and subsequent antifungal treatment led to a positive outcome.

Implications:

  • This case expands the understanding of risk factors for invasive aspergillosis, suggesting nasal corticosteroid use as a potential contributing factor in non-immunocompromised individuals.
  • Highlights the importance of considering invasive fungal sinusitis in the differential diagnosis of unilateral headache and optic neuropathy, even in the absence of traditional risk factors.
  • Emphasizes the successful management through surgical intervention and antifungal therapy, offering a treatment paradigm for similar complex cases.

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