| Identifier |
walsh_2015_s2_c4 |
| Title |
Hiding and Out of Sight |
| Creator |
Michael L. Morgan; Sumayya J. Almarzouqi; Patricia Chevez-Barrios; Amina I. Malik; Andrew G. Lee |
| Affiliation |
Houston Methodist Hospital, Department of Ophthalmology Houston, TX |
| Subject |
Giant Cell Arteritis; Infection; Temporal Artery Biopsy |
| Description |
Repeat MRI showed progression of the left-sided lesion involving the orbital apex as well as the cavernous sinus, adjacent dura mater, and neighboring ethmoid sinus. Lumbar puncture was non-diagnostic. Left orbitotomy revealed a purulent collection. Microscopic examination and culture showed Aspergillus fumigatus (Wiggin 1995, Hutnik et al 1997). Anti-fungal treatment with systemic voriconazole and local amphotericin B was initiated. |
| History |
A 75-year-old white woman presented with a history of biopsy-proven giant cell arteritis (GCA)presented with recurrence of severe left sided headaches and left global ophthalmoparesis for 4 days.GCA had been diagnosed 4 months prior by biopsy. Left eye vision loss occurred when an outsidephysician tapered corticosteroid therapy 5 weeks into her illness. MRI 5 weeks into her illness showedenhancement of the left orbital apex, adjacent temporal dura and neighboring cavernous sinus. Duralbiopsy at that time was normal, and a second temporal artery biopsy performed then confirmed GCA.Examination was remarkable for left eye vision loss to no light perception with an amaurotic pupil andglobal left ophthalmoparesis including ptosis and pupil involvement with a normal fundus. Repeat MRIshowed progression of the prior lesions. A diagnostic procedure was performed. |
| Disease/Diagnosis |
Orbital aspergillosis |
| Date |
2015-02 |
| References |
1. Wiggins RE Jr. Invasive aspergillosis. A complication of treatment of temporal arteritis. J Neuroophthalmol. 1995 Mar;15(1):36-8. 2. Hutnik CM, Nicolle DA, Munoz DG. Orbital aspergillosis. A fatal masquerader. J Neuroophthalmol. 1997 Dec;17(4):257- 61. |
| Language |
eng |
| Format |
application/pdf |
| Format Creation |
Microsoft PowerPoint |
| Type |
Text |
| Source |
47th Annual Frank Walsh Society Meeting |
| Relation is Part of |
NANOS Annual Meeting 2015 |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6516vts |
| Setname |
ehsl_novel_fbw |
| ID |
179297 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6516vts |
