title: Sudden loss of vision in an Acute Medical Unit.
abstract: We present a case report of young man with Type 1 diabetes who developed acute visual loss after initially presenting with diabetic ketoacidosis. The diagnosis of invasive paranasal sinusoidal aspergillosis was made following CT and biopsy. Although uncommon, visual loss is a recognised complication of disseminated aspergillosis and is more likely in immune-compromised patients and those with diabetes. Early investigation with appropriate sinus imaging and involvement of the Ear Nose and Throat team in recommended when patients with diabetes develop acute visual loss in the context of a non-specific infective illness.
authors.affiliation: Consultant Acute Medicine, Watford General Hospital, Watford.
authors.forename: M
authors.initials: M
authors.lastname: Arif
authors.forename: J
authors.initials: J
authors.lastname: Jordaan
authors.forename: V
authors.initials: V
authors.lastname: Garcia Arias
mesh_terms: D000208:Acute Disease; D000666:Amphotericin B / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D001706:Biopsy; D001766:Blindness / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology*; D000077336:Caspofungin; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003937:Diagnosis, Differential; D054714:Echinocandins / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D017809:Fatal Outcome; D006801:Humans; D055666:Lipopeptides; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D000077731:Meropenem; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D013845:Thienamycins / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D013845:Thienamycins; C068538:liposomal amphotericin B; D000666:Amphotericin B; D000077336:Caspofungin; D000077731:Meropenem