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Orbital aspergillosis. A fatal masquerader
C M Hutnik1, D A Nicolle, D G Munoz
1Department of Ophthalmology, University of Western Ontario, London, Canada.
Summary
Aspergillosis, a fungal infection, can present atypically in the eye and orbit, even in immunocompetent individuals. Prompt biopsy is crucial for diagnosing aggressive orbital aspergillosis that mimics other conditions like temporal arteritis.
Area of Science:
- Ophthalmology
- Mycology
- Pathology
Background:
- Aspergillosis traditionally presents as endogenous endophthalmitis in immunocompromised patients.
- Ocular aspergillosis diagnosis often has a low index of suspicion, particularly in immunocompetent individuals.
Observation:
- Atypical presentations of ocular and orbital aspergillosis are increasingly reported.
- This case involved orbital aspergillosis mimicking temporal arteritis, showing an unusual clinical presentation.
Findings:
- Autopsy confirmed orbital aspergillosis with a presentation resembling temporal arteritis.
- The condition exhibited rapid, uncontrollable progression, a hallmark of severe Aspergillus involvement.
Implications:
- Ocular conditions with subtle atypical features, including temporal arteritis, warrant high suspicion for fungal infection.
- Aggressive diagnostic approaches, such as biopsy of involved sites, are essential for timely and accurate diagnosis of orbital aspergillosis.