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• Vol.47 No.5
• CLINICA NEUROL, 47: 207−210, 2007
• Vol.47 No.5 contents

Case Report

A case of orbital apex syndrome caused by localized invasive aspergillosis successfully treated with voriconazole

Atsushi Kuga, M.D.¹⁾, Kenichi Oishi, M.D.¹⁾, Haruhiko Ishida, M.D.²⁾ and Fumio Kanda, M.D.¹⁾

¹⁾Department of Neurology, Kobe University Hospital
²⁾Department of Otorhinolaryngology-Head and Neck Surgery, Kobe University Hospital

A 71-year-old man with left periorbital pain and diplopia was hospitalized for evaluation and treatment. He had a past history of untreated diabetes mellitus. Shortly after admission, the patient experienced rapid onset of visual loss in the left eye. MRI and CT showed a lesion expanding from the left orbital apex to the left pterygopalatine fossa. Invasive aspergillosis was diagnosed by open biopsy of intrasinus mucosa via the left maxillary sinus. The patient was treated with voriconazole, an antifungal agent, and marked improvements in left periorbital pain and eye movement were subsequently obtained, although visual acuity was not recovered. This is the first report documenting the clinical utility of voriconazole for sino-orbital invasive aspergillosis.

(CLINICA NEUROL, 47: 207−210, 2007)
key words: orbital apex syndrome, aspergillus, voriconazole

(Received: 7-Aug-06)