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Published on: April 14, 2014
Neuro-ophthalmic manifestations of fungal disease associated with posthurricane environment
Jayanth Sridhar1, Byron L Lam, Joshua Pasol
1Bascom Palmer Eye Institute, Miami, FL 33136, USA.
Background:
Allergic fungal sinusitis (AFS) is thought to represent an immunologic response to exposure to dematiaceous fungi. These fungi are known to cause disease more frequently in hot and humid climates and seasons.
Methods:
Three patients presented with unusual manifestations of fungal disease after exposure to environments recently affected by hurricanes.
Results:
Two patients had AFS, 1 with gradual painless visual loss from an AFS mass extending into the suprasellar region and 1 with orbital apex syndrome. Another patient had invasive fungal disease and developed orbital apex syndrome.
Conclusions:
These cases underscore the importance of clinical recognition of fungal disease in patients with sinus, orbital, or skull base involvement as well as its potential for causing permanent visual loss. This report suggests a potential association between fungal disease and tropical storm exposure.
Insights
Allergic fungal sinusitis (AFS) can cause vision loss after fungal exposure, particularly in humid climates. This study suggests a link between tropical storms and severe fungal infections affecting the sinuses and orbits.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Mycology
Background:
- Allergic fungal sinusitis (AFS) is an immune response to dematiaceous fungi.
- These fungi thrive in hot, humid conditions.
Observation:
- Three patients developed fungal disease after hurricane exposure.
- Two patients had AFS with vision loss or orbital apex syndrome.
- One patient had invasive fungal disease and orbital apex syndrome.
Findings:
- AFS can lead to vision loss via mass effect.
- Orbital apex syndrome is a potential complication.
- Invasive fungal disease can also occur.
Implications:
- Early recognition of fungal disease is crucial for sinus, orbital, and skull base issues.
- Fungal infections may be associated with tropical storm exposure.
- Prompt diagnosis and treatment can prevent permanent visual impairment.
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