|Fungal orbital infections: presenting features, management and outcomes at a referral center in Egypt|| |
|Tanta University Eye Hospital, Tanta, Egypt|
|Purpose: Fungal infections of the orbit are relatively rare and can mimic other infectious, inflammatory and neoplastic conditions of the orbit, thereby delaying the diagnosis in some cases. Till now fungal infections still life and sight threatening. The purpose of this study is to describe the clinical presentations and diagnostic features of fungal infections of orbit. our regimen in dealing with this serious infection together with its outcome are presented|
Methods: Medical records of all cases of biopsy proven fungal infection of the orbit presented to Tanta University Eye Hospital between Jan 2000 and June 2017 were retrospectively reviewed. Orbital imaging was done in all patients. Diagnosis was achieved in all cases by histopathological and/or microbiological examination of orbital or sinus biopsy material. Management protocol based on early diagnosis, early correction of the metabolic state, Amphotericin B IV and local nasal irrigation combined with repeated debridement.
Results: Tthirty five patients with fungal orbital infections 20 male and 15 female .Age of the patients was 45 years with a range of 9 to 78 years. Thirty-two were unilateral and 3 had bilateral affection. In 5 patients, the presentation was acute resembling acute bacterial orbital cellulitis. In 25 cases was insidious orbital apex yndrome. Predisposing conditions included uncontrolled diabetes (68%), periorbital trauma (11%) and chemotherapy (9%). With our treatment regimen only 2 cases died, 3 cases ended with excentration, 3 cases regained useful vision all the other cases the infection was controlled and the eyes preserved.'
Conclusions: As fungal orbital infections still carry a poor prognosis it is important to recognize the disease early and institute appropriate treatment to minimize the morbidity and mortality. Keeping high index of suspension is mandatory. Our regimen markedly reduced the mortality rate but still recovery of useful vision is still unsatisfactory.
professor Ophthalmology Mohamed Eldesouky , Tanta University Eye Hospital , Tanta , Egypt
Assigned in sessions:
16.06.2019, 10:00-11:30, Free Papers/Rapid Fire, FP15, Oculoplastics, Refractive Surgery, Galliéni 1+2