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Three-Dimensional Reconstruction of Orbital Fractures

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Published on: May 16, 2025

[Orbital mycetoma: a case report].

N N Gueye¹, S M Seck, Y Diop

¹Service d'ophtalmologie, hôpital principal de Dakar, 1, avenue Nelson-Mandela, BP 3006, Dakar, Sénégal. nng67@hotmail.com

Journal Francais D'Ophtalmologie

|January 30, 2013

Summary

Orbital mycetoma, a rare fungal infection, can occur after traumatic injury. Surgical removal and antifungal treatment are crucial for favorable outcomes, preventing recurrence of this mycetoma.

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Area of Science:

Ophthalmology
Mycology
Infectious Diseases

Background:

Mycetomas are infections caused by soil-dwelling fungi or actinomycetes, typically introduced via trauma, most commonly affecting the foot.
Orbital mycetoma is an exceptionally rare presentation of this disease.

Observation:

A 17-year-old presented with a 2-year history of progressive proptosis due to a penetrating eye injury.
Clinical examination revealed an orbital mass with fistulae discharging pus and black grains, suggesting fungal mycetoma.
MRI showed ethmoid and orbital floor destruction; histopathology confirmed a fungal infection.

Findings:

Black grains are indicative of fungal mycetoma, necessitating aggressive surgical management.
Complete surgical debridement, including exenteration and sinus clearance, alongside antifungal therapy, led to a favorable outcome.
No recurrence was observed 14 months post-surgery.

Implications:

This case highlights the importance of considering mycetoma in orbital infections, especially after trauma in endemic areas.
The color of grains is a key diagnostic clue for fungal versus actinomycotic mycetoma.
Aggressive surgical treatment, akin to cancer management, is vital for preventing recurrence in orbital mycetoma.