Necrotizing periorbital Fusarium infection--an emerging pathogen in immunocompetent individuals.
Fungal infections of the skin and deeper tissues of the periorbital region are quite rare. We report a case of a localized, deep periorbital necrotizing Fusarium infection in an otherwise healthy, elderly lady. Since the clinical features and histopathological findings of Fusarium infection are by no means characteristic, the definitive diagnosis was achieved with the help of microbiological examination of cultured organisms. A combined medical and surgical therapy led to adequate control of infection. To conclude, localized, deep periorbital necrotizing soft tissue infection by Fusarium in an immunocompetent lady is not reported in literature. One should have a high index of suspicion for emerging fungal pathogens in the differential diagnosis of necrotizing orbital or adnexal conditions, even in an immunocompetent patient. The histologic findings of septate, branching hyphae and vascular invasion cannot distinguish Fusarium species from various other moulds such as Aspergillus species; microbiologic studies are essential for confirming the diagnosis.
Pushker
N
N
Oculoplastic and Paediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110 029, India.
Chra
M
M
Bajaj
M S
MS
Ghose
S
S
Naik
N
N
Kashyap
S
S
Satpathy
G
G
D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002386:Cataract / Q000628:therapy; D003022:Clotrimazole / Q000627:therapeutic use; D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000382:microbiology*; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005670:Fusarium / Q000302:isolation & purification*; D006801:Humans; D007121:Immunocompetence; D019654:Lens Implantation, Intraocular / Q000009:adverse effects; D008875:Middle Aged
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D000666:Amphotericin B; D003022:Clotrimazole