title: [Case of orbital apex syndrome caused by invasive aspergillosis successfully treated during the diagnostic procedure by the use of voriconazole].
abstract: A 75-year-old woman developed loss of vision and decreased ocular motility in all directions. She exhibited a left orbital apex syndrome, accompanied by sphenoiditis and hypertrophic pachymeningitis. Voriconazole treatment was initiated on the basis of clinical suspicion, although use of the serum beta-D glucan had negative results and a biopsy was not performed. Five days later, the left eye movements started to improve, and at that time the use of the serum aspergillus galactomannan antigen proved to have positive results. Six months later, the patient was neurologically intact and stable, except for a lack of visual acuity in counting fingers. Earlier prognoses of invasive sino-orbital aspergillosis were dismal, especially when corticosteroid therapy was done before diagnosis. This case suggests the usefulness of antifungal agents during the diagnostic procedure even when localized invasive aspergillosis is not ruled out.
authors.affiliation: Department of Neurology, Nagaoka Red Cross Hospital.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sugai
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Oyake
authors.forename: Maiko
authors.initials: M
authors.lastname: Umeda
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Umeda
authors.forename: Nobuya
authors.initials: N
authors.lastname: Fujita
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D015835:Ocular Motility Disorders / Q000188:drug therapy* / Q000209:etiology*; D009916:Orbital Diseases / Q000188:drug therapy* / Q000209:etiology*; D011743:Pyrimidines / Q000008:administration & dosage*; D013577:Syndrome; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage*; D014786:Vision Disorders / Q000188:drug therapy* / Q000209:etiology*; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole