title: Successful treatment of invasive cavernous sinus aspergillosis with oral itraconazole monotherapy.
abstract: An 83-year-old woman receiving long-term prednisolone treatment presented with a right optic neuropathy and right third, fourth, fifth, and sixth cranial nerve palsies secondary to sino-orbital aspergillosis with cavernous sinus involvement. Because the patient refused conventional treatment, she was given a two-year course of oral itraconazole 200 mg/day, leading to a complete imaging resolution of the lesion. Three years after completing treatment, there is no clinical or imaging evidence of disease recurrence. Visual and ocular motor function did not recover, but ptosis and proptosis improved. We believe this to be the first documented case of successful treatment of such a lesion with oral itraconazole monotherapy.
authors.affiliation: Department of Ophthalmology, University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Browning
authors.forename: Kuan T
authors.initials: KT
authors.lastname: Sim
authors.forename: Judith M
authors.initials: JM
authors.lastname: Timms
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Vernon
authors.forename: Norman S
authors.initials: NS
authors.lastname: McConachie
authors.forename: Richard
authors.initials: R
authors.lastname: Allibone
authors.forename: Nick S
authors.initials: NS
authors.lastname: Jones
mesh_terms: D000284:Administration, Oral; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D001230:Aspergillus / Q000235:genetics / Q000302:isolation & purification*; D001706:Biopsy; D002426:Cavernous Sinus / Q000382:microbiology*; D004271:DNA, Fungal / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging
chemical_list: D000935:Antifungal Agents; D004271:DNA, Fungal; D017964:Itraconazole