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Bipolaris-induced orbital cellulitis.

M Jacobson1, S L Galetta, S W Atlas

  • 1Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia.

Journal of Clinical Neuro-Ophthalmology
|December 1, 1992
PubMed
Summary
This summary is machine-generated.

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A patient developed unilateral proptosis and ophthalmoplegia after trauma. Fungal sinusitis caused by Bipolaris species, not Aspergillus, was identified, impacting eye movement more than vision.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Radiology

Background:

  • Allergic fungal sinusitis can present with orbital complications.
  • Bipolaris species are increasingly recognized as causative agents in invasive fungal sinusitis.

Observation:

  • A patient presented with unilateral proptosis and complete ophthalmoplegia after blunt orbital trauma.
  • Computed tomography (CT) scan showed a paranasal sinus mass eroding the cribriform plate into the orbit.

Findings:

  • Initial biopsy suggested allergic Aspergillus sinusitis, but cultures identified Bipolaris species.
  • Literature review indicates Bipolaris is more common than Aspergillus in orbital fungal sinusitis.
  • Proptosis and extraocular motility impairment are more frequent than visual loss in these cases.

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Implications:

  • Accurate fungal identification is crucial for appropriate treatment of orbital fungal sinusitis.
  • Early recognition and management of Bipolaris sinusitis can prevent severe ocular complications.
  • Surgical management combined with corticosteroids is a common therapeutic approach, though controversial.