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Published on: March 18, 2020

Concurrent sino-orbital aspergillosis and cerebral nocardiosis

Liselotte Pieroth1, Jacqueline M S Winterkorn, Hermann Schubert

  • 1Department of Ophthalmology, The New York Presbyterian Hospital-Columbia University Medical College, New York, New York, USA.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|June 5, 2004
PubMed

Insights

This case report details a rare instance of simultaneous sino-orbital aspergillosis and cerebral nocardiosis in an immunocompromised patient. Both infections were successfully treated, with most neurological functions recovering.

Area of Science:

  • Ophthalmology
  • Neurology
  • Infectious Diseases

Background:

  • Myelodysplastic syndrome (MDS) can predispose patients to opportunistic infections.
  • Orbital and cerebral infections require prompt diagnosis and treatment, especially in immunocompromised individuals.

Observation:

  • A 79-year-old man with MDS presented with optic neuropathy, periocular pain, and cranial nerve palsies.
  • Imaging revealed an orbital apex mass (Aspergillus fumigatus) and later, multiple cerebral masses (Nocardia asteroides).

Findings:

  • The patient was diagnosed with concurrent sino-orbital aspergillosis and cerebral nocardiosis.
  • Successful treatment with appropriate antimicrobial therapy led to recovery of neurological function, excluding optic neuropathy.

Implications:

  • This case highlights the possibility of concurrent, distinct opportunistic infections in immunocompromised patients.
  • Early neuro-ophthalmologic and advanced imaging are crucial for diagnosing complex infections in this population.

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