title: Aspergillus infection of supramid orbital implant and hyperostosis of orbital bone: report of a unique case.
abstract: OBJECTIVE
  The authors report the clinical findings in a patient who developed proptosis fourteen years after an orbital floor fracture repair with a Supramid orbital implant due to hyperostosis of the orbital floor and lateral orbital wall bone secondary to aspergillus infection.
  
  
  METHODS
  Clinical, radiological, microbiological and histological findings and the management of this patient are presented.
  
  
  RESULTS
  A 25-year-old male was referred with proptosis and lower lid retraction, fourteen years after a traumatic orbital floor fracture repair with a Supramid implant. Orbital exploration revealed a thick irregular sheet of bone covering the orbital floor implant and extending laterally along the lateral orbital wall. Aspergillus fumigatus was grown from the Supramid implant as well as from the bone and histology showed chronic inflammatory process with reactive bone formation. Patient was treated with a course of oral Voriconazole and post-operatively the patient is asymptomatic with reduction in proptosis.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first case of Apergillus fumigatus infection secondary to a Supramid orbital floor implant, associated with hyperostosis of orbital bone.
authors.affiliation: Oculoplastic and Orbit Division, Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
authors.forename: Purnima
authors.initials: P
authors.lastname: Mehta
authors.forename: Varajini
authors.initials: V
authors.lastname: Joganathan
authors.forename: Beryl
authors.initials: B
authors.lastname: Oppenheim
authors.forename: Omar M
authors.initials: OM
authors.lastname: Durrani
mesh_terms: D000328:Adult; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy; D001230:Aspergillus / Q000187:drug effects / Q000302:isolation & purification; D003131:Combined Modality Therapy; D020878:Device Removal; D005500:Follow-Up Studies; D006801:Humans; D015576:Hyperostosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D009757:Nylons / Q000009:adverse effects; D009917:Orbital Fractures / Q000601:surgery; D020273:Orbital Implants / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000628:therapy; D011743:Pyrimidines / Q000008:administration & dosage; D011859:Radiography; D018570:Risk Assessment; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage; D065819:Voriconazole
chemical_list: D009757:Nylons; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole