Faculty Collaboration Database

Orbital aspergillosis. Conservative debridement and local amphotericin irrigation. Ophthalmic Plast Reconstr Surg 1989;5(3):207-11

Date

01/01/1989

Pubmed ID

2487225

DOI

10.1097/00002341-198909000-00012

Scopus ID

2-s2.0-0024453897 (requires institutional sign-in at Scopus site)   45 Citations

Abstract

A patient maintained on long-term immunosuppressive agents after bone marrow transplantation developed an Aspergillus abscess in the right orbit. The abscess was resected without visual compromise and the orbit was irrigated regularly with amphotericin B via an indwelling catheter. Follow-up computed tomography, surgical exploration, and histological analysis demonstrated suppression of fungal growth in the orbit. Persistent fungus was recovered from nonirrigated sinuses despite their previous surgical evacuation and continued systemic amphotericin B administration. Treatment of orbital aspergillosis should include surgical reduction of the local fungal inoculum, supplementation of intravenous antifungal agents with local delivery to minimize systemic toxicity, and attempts to reverse the immunosuppression. If the last is not possible, extensive extirpation of normal surrounding tissues will not prevent repopulation by the ubiquitous fungus.

Author List

Harris GJ, Will BR

Author

Gerald J. Harris MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Amphotericin B
Aspergillosis
Bone Marrow Transplantation
Catheters, Indwelling
Debridement
Ethmoid Sinusitis
Female
Humans
Injections, Intravenous
Leukemia, Myeloid, Acute
Orbital Diseases