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Fungus That Struck the Brain: A Case of Invasive Sino-Orbital Aspergillosis Causing a Stroke

Nidha Shapoo1, Jumana Chalabi1, Paul Huang2

  • 1Internal Medicine, New York Medical College, Metropolitan Hospital Center, New York, USA.

Cureus
|June 18, 2025
PubMed

Insights

Invasive sino-orbital aspergillosis, a rare fungal infection, can cause devastating carotid artery invasion and stroke. Early diagnosis and multidisciplinary care are crucial for managing this condition and preventing fatal vascular complications.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Ophthalmology

Background:

  • Invasive sino-orbital aspergillosis is a rare, life-threatening fungal infection.
  • It primarily impacts immunocompromised individuals, posing risks of severe vascular complications.

Observation:

  • A 74-year-old male with diabetes presented with eye pain and proptosis.
  • Imaging showed a sino-orbital mass invading the cavernous sinus and internal carotid artery.

Findings:

  • The patient experienced an ischemic stroke post-biopsy due to carotid artery occlusion, necessitating mechanical thrombectomy.
  • Histopathology confirmed Aspergillus fumigatus; treatment with amphotericin B and voriconazole led to improvement.

Implications:

  • This case underscores the critical need for prompt diagnosis of sino-orbital aspergillosis.
  • A multidisciplinary approach is essential to prevent fatal vascular complications like stroke.
Keywords:
carotiditisinvasive aspergillosisorbital apex syndromesino-orbital infectionstroke

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