Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment
In immunocompromised patients, symptoms and the pathogen spectrum of sinusitis are frequently atypical. If progressive loss of vision occurs, an infection of the anterior skull base or nasal sinuses should be considered. We report on four patients with orbit-associated symptoms. CT-imaging revealed...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2009-01, Vol.266 (1), p.71-76 |
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| creator | Arndt, Susan Aschendorff, Antje Echternach, Matthias Daemmrich, Tanja Daniela Maier, Wolfgang |
| description | In immunocompromised patients, symptoms and the pathogen spectrum of sinusitis are frequently atypical. If progressive loss of vision occurs, an infection of the anterior skull base or nasal sinuses should be considered. We report on four patients with orbit-associated symptoms. CT-imaging revealed bony defects in sinus borders to orbits or endocranium. In all the cases immediate surgical drainage was performed because complications following sinusitis were suspected. Histopathological diagnosis revealed two cases of aspergillosis and mucormycosis. The possibility of opportunistic infections by saprophytic fungi must be taken into account in immunocompromised patients, as they may endanger both vision and survival. Immediate diagnosis and therapy are essential. Nowadays, therapeutic success can be achieved due to advances in antimicrobial therapy, hyperbaric oxygen therapy and treatment of the underlying disease. Radical procedures like orbital exenteration must be considered in all cases. The current state of diagnostics, therapy and prognosis is discussed based on these case reports and the recent literature. |
| doi_str_mv | 10.1007/s00405-008-0692-y |
| format | Article |
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If progressive loss of vision occurs, an infection of the anterior skull base or nasal sinuses should be considered. We report on four patients with orbit-associated symptoms. CT-imaging revealed bony defects in sinus borders to orbits or endocranium. In all the cases immediate surgical drainage was performed because complications following sinusitis were suspected. Histopathological diagnosis revealed two cases of aspergillosis and mucormycosis. The possibility of opportunistic infections by saprophytic fungi must be taken into account in immunocompromised patients, as they may endanger both vision and survival. Immediate diagnosis and therapy are essential. Nowadays, therapeutic success can be achieved due to advances in antimicrobial therapy, hyperbaric oxygen therapy and treatment of the underlying disease. Radical procedures like orbital exenteration must be considered in all cases. The current state of diagnostics, therapy and prognosis is discussed based on these case reports and the recent literature.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-008-0692-y</identifier><identifier>PMID: 18470529</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Aged ; Aged, 80 and over ; Antifungal Agents - therapeutic use ; Antimicrobial agents ; Aspergillosis - diagnosis ; Aspergillosis - diagnostic imaging ; Aspergillosis - drug therapy ; Aspergillus ; Biological and medical sciences ; Diagnosis, Differential ; Eye Infections, Fungal - diagnosis ; Eye Infections, Fungal - diagnostic imaging ; Eye Infections, Fungal - drug therapy ; Follow-Up Studies ; Head and Neck Surgery ; Human mycoses ; Humans ; Immunocompromised Host ; Infectious diseases ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Miscellaneous mycoses ; Mucorales - isolation & purification ; Mucormycosis - diagnosis ; Mucormycosis - diagnostic imaging ; Mucormycosis - drug therapy ; Mycoses ; Neurosurgery ; Orbital Diseases - diagnosis ; Orbital Diseases - diagnostic imaging ; Orbital Diseases - drug therapy ; Orbital Diseases - mortality ; Otorhinolaryngology ; Otorhinolaryngology. Stomatology ; Paranasal Sinus Diseases - diagnosis ; Paranasal Sinus Diseases - diagnostic imaging ; Paranasal Sinus Diseases - drug therapy ; Paranasal Sinus Diseases - mortality ; Phycomycoses ; Rhinology ; Risk Assessment ; Sampling Studies ; Severity of Illness Index ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome ; Tropical mycoses</subject><ispartof>European archives of oto-rhino-laryngology, 2009-01, Vol.266 (1), p.71-76</ispartof><rights>Springer-Verlag 2008</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-1408ffc176e987adc16b24919570c7686d4878d0ce7247f6d78ad41af81841ee3</citedby><cites>FETCH-LOGICAL-c470t-1408ffc176e987adc16b24919570c7686d4878d0ce7247f6d78ad41af81841ee3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-008-0692-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-008-0692-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21012240$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18470529$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arndt, Susan</creatorcontrib><creatorcontrib>Aschendorff, Antje</creatorcontrib><creatorcontrib>Echternach, Matthias</creatorcontrib><creatorcontrib>Daemmrich, Tanja Daniela</creatorcontrib><creatorcontrib>Maier, Wolfgang</creatorcontrib><title>Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>In immunocompromised patients, symptoms and the pathogen spectrum of sinusitis are frequently atypical. If progressive loss of vision occurs, an infection of the anterior skull base or nasal sinuses should be considered. We report on four patients with orbit-associated symptoms. CT-imaging revealed bony defects in sinus borders to orbits or endocranium. In all the cases immediate surgical drainage was performed because complications following sinusitis were suspected. Histopathological diagnosis revealed two cases of aspergillosis and mucormycosis. The possibility of opportunistic infections by saprophytic fungi must be taken into account in immunocompromised patients, as they may endanger both vision and survival. Immediate diagnosis and therapy are essential. Nowadays, therapeutic success can be achieved due to advances in antimicrobial therapy, hyperbaric oxygen therapy and treatment of the underlying disease. Radical procedures like orbital exenteration must be considered in all cases. The current state of diagnostics, therapy and prognosis is discussed based on these case reports and the recent literature.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Antimicrobial agents</subject><subject>Aspergillosis - diagnosis</subject><subject>Aspergillosis - diagnostic imaging</subject><subject>Aspergillosis - drug therapy</subject><subject>Aspergillus</subject><subject>Biological and medical sciences</subject><subject>Diagnosis, Differential</subject><subject>Eye Infections, Fungal - diagnosis</subject><subject>Eye Infections, Fungal - diagnostic imaging</subject><subject>Eye Infections, Fungal - drug therapy</subject><subject>Follow-Up Studies</subject><subject>Head and Neck Surgery</subject><subject>Human mycoses</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Infectious diseases</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Miscellaneous mycoses</subject><subject>Mucorales - isolation & purification</subject><subject>Mucormycosis - diagnosis</subject><subject>Mucormycosis - diagnostic imaging</subject><subject>Mucormycosis - drug therapy</subject><subject>Mycoses</subject><subject>Neurosurgery</subject><subject>Orbital Diseases - diagnosis</subject><subject>Orbital Diseases - diagnostic imaging</subject><subject>Orbital Diseases - drug therapy</subject><subject>Orbital Diseases - mortality</subject><subject>Otorhinolaryngology</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Paranasal Sinus Diseases - diagnosis</subject><subject>Paranasal Sinus Diseases - diagnostic imaging</subject><subject>Paranasal Sinus Diseases - drug therapy</subject><subject>Paranasal Sinus Diseases - mortality</subject><subject>Phycomycoses</subject><subject>Rhinology</subject><subject>Risk Assessment</subject><subject>Sampling Studies</subject><subject>Severity of Illness Index</subject><subject>Survival Rate</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Tropical mycoses</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEQgIMotlZ_gBfpRTxFJ9k0yXqT4gsKgujJQ8jmUVP2UZPdQ_-9KS315mlg5pvXh9AlgVsCIO4SAIMZBpAYeEnx5giNCSsYZoLyYzSGshCYMSFG6CylFQDMWFmcohGRTMCMlmP09f4d2g53sQq9rrFx0VVR19NmMF1sNqZLIU11a6c6rV1chrreZu6nNnif2bYPGbZBL9sD2Uen-yaXztGJ13VyF_s4QZ9Pjx_zF7x4e36dPyywyVf0mDCQ3hsiuCul0NYQXlFWknImwAguuWVSSAvGCcqE51ZIbRnRXuY3iHPFBN3s5q5j9zO41KsmJOPqWreuG5IqQRDOJC8ySXakiV1K0Xm1jqHRcaMIqK1StVOqslK1Vao2uedqP32oGmf_OvYOM3C9B3QyuvZRtyakA0cJEEoZZI7uuJRL7dJFteqG2GYz_2z_BTW8j_0</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Arndt, Susan</creator><creator>Aschendorff, Antje</creator><creator>Echternach, Matthias</creator><creator>Daemmrich, Tanja Daniela</creator><creator>Maier, Wolfgang</creator><general>Springer-Verlag</general><general>Springer</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>M7N</scope></search><sort><creationdate>20090101</creationdate><title>Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment</title><author>Arndt, Susan ; Aschendorff, Antje ; Echternach, Matthias ; Daemmrich, Tanja Daniela ; Maier, Wolfgang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-1408ffc176e987adc16b24919570c7686d4878d0ce7247f6d78ad41af81841ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Antimicrobial agents</topic><topic>Aspergillosis - diagnosis</topic><topic>Aspergillosis - diagnostic imaging</topic><topic>Aspergillosis - drug therapy</topic><topic>Aspergillus</topic><topic>Biological and medical sciences</topic><topic>Diagnosis, Differential</topic><topic>Eye Infections, Fungal - diagnosis</topic><topic>Eye Infections, Fungal - diagnostic imaging</topic><topic>Eye Infections, Fungal - drug therapy</topic><topic>Follow-Up Studies</topic><topic>Head and Neck Surgery</topic><topic>Human mycoses</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Infectious diseases</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Miscellaneous mycoses</topic><topic>Mucorales - isolation & purification</topic><topic>Mucormycosis - diagnosis</topic><topic>Mucormycosis - diagnostic imaging</topic><topic>Mucormycosis - drug therapy</topic><topic>Mycoses</topic><topic>Neurosurgery</topic><topic>Orbital Diseases - diagnosis</topic><topic>Orbital Diseases - diagnostic imaging</topic><topic>Orbital Diseases - drug therapy</topic><topic>Orbital Diseases - mortality</topic><topic>Otorhinolaryngology</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Paranasal Sinus Diseases - diagnosis</topic><topic>Paranasal Sinus Diseases - diagnostic imaging</topic><topic>Paranasal Sinus Diseases - drug therapy</topic><topic>Paranasal Sinus Diseases - mortality</topic><topic>Phycomycoses</topic><topic>Rhinology</topic><topic>Risk Assessment</topic><topic>Sampling Studies</topic><topic>Severity of Illness Index</topic><topic>Survival Rate</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Tropical mycoses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arndt, Susan</creatorcontrib><creatorcontrib>Aschendorff, Antje</creatorcontrib><creatorcontrib>Echternach, Matthias</creatorcontrib><creatorcontrib>Daemmrich, Tanja Daniela</creatorcontrib><creatorcontrib>Maier, Wolfgang</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arndt, Susan</au><au>Aschendorff, Antje</au><au>Echternach, Matthias</au><au>Daemmrich, Tanja Daniela</au><au>Maier, Wolfgang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>266</volume><issue>1</issue><spage>71</spage><epage>76</epage><pages>71-76</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>In immunocompromised patients, symptoms and the pathogen spectrum of sinusitis are frequently atypical. If progressive loss of vision occurs, an infection of the anterior skull base or nasal sinuses should be considered. We report on four patients with orbit-associated symptoms. CT-imaging revealed bony defects in sinus borders to orbits or endocranium. In all the cases immediate surgical drainage was performed because complications following sinusitis were suspected. Histopathological diagnosis revealed two cases of aspergillosis and mucormycosis. The possibility of opportunistic infections by saprophytic fungi must be taken into account in immunocompromised patients, as they may endanger both vision and survival. Immediate diagnosis and therapy are essential. Nowadays, therapeutic success can be achieved due to advances in antimicrobial therapy, hyperbaric oxygen therapy and treatment of the underlying disease. Radical procedures like orbital exenteration must be considered in all cases. The current state of diagnostics, therapy and prognosis is discussed based on these case reports and the recent literature.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>18470529</pmid><doi>10.1007/s00405-008-0692-y</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Antifungal Agents - therapeutic use Antimicrobial agents Aspergillosis - diagnosis Aspergillosis - diagnostic imaging Aspergillosis - drug therapy Aspergillus Biological and medical sciences Diagnosis, Differential Eye Infections, Fungal - diagnosis Eye Infections, Fungal - diagnostic imaging Eye Infections, Fungal - drug therapy Follow-Up Studies Head and Neck Surgery Human mycoses Humans Immunocompromised Host Infectious diseases Magnetic Resonance Imaging Male Medical sciences Medicine Medicine & Public Health Middle Aged Miscellaneous mycoses Mucorales - isolation & purification Mucormycosis - diagnosis Mucormycosis - diagnostic imaging Mucormycosis - drug therapy Mycoses Neurosurgery Orbital Diseases - diagnosis Orbital Diseases - diagnostic imaging Orbital Diseases - drug therapy Orbital Diseases - mortality Otorhinolaryngology Otorhinolaryngology. Stomatology Paranasal Sinus Diseases - diagnosis Paranasal Sinus Diseases - diagnostic imaging Paranasal Sinus Diseases - drug therapy Paranasal Sinus Diseases - mortality Phycomycoses Rhinology Risk Assessment Sampling Studies Severity of Illness Index Survival Rate Tomography, X-Ray Computed Treatment Outcome Tropical mycoses |
| title | Rhino-orbital-cerebral mucormycosis and aspergillosis: differential diagnosis and treatment |
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