FP1652 : Aspergillosis involving the para nasal sinuses- a rare cause of orbital cellulitis

Dr.Shivcharan Lal Chandravanshi, C11551

Invasive orbital aspergillosis is a rare clinical entity in immunocompetent patients. A 55 years old male patient presented with severe headache, massive proptosis of the left eye. He was known diabetic since 8 years. The visual acuity was 1/60. Slit lamp examination showed 5 mm eccentric proptosis, chemosis, RAPD and complete restriction of intraocular movements. Proptosis was non-reducible and painful. Oral examination showed oropharyngeal ulcerative lesions. Computerized tomography scan of orbit and paranasal sinuses revealed complete opacification of maxillary and ethmoidal sinuses and intra and extraconal collection in orbit. Lab investigations found fasting blood sugar was 155mg% and post prandial 556mg%. Culture from oral lesions, sinus and conjunctival swab grew Aspergillus flavus. He was treated with systemic voriconazole and sinus surgery. Diabetes was controlled with Insulin. He was recovered completely. Morbidity and mortality may be avoided with timely management.