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TitreDifferent presentations of ophtalmic aspergillosis
Abstract Nr.P02
ButTo describe three patients with different ophthalmic lesions due to aspergillus.
MéthodesCase reports
RésultatsThe first patient was treated with methylprednisolone (MPS) for autoimmune hepatitis. She complained of blurred vision in her right eye and had a uveitis with hypopyon. General work-up revealed pulmonary and brain lesions suggestive of aspergillosis. Immunologic testing was positive for aspergillus. Her general status degraded rapidly and she died despite antimycotic therapy. The second patient had a history of sarcoïdosis and developed a right hemicranial pain with vision loss and optic nerve oedema. An orbital lesion was demonstrated by CT scan and was unresponsive to MPS. A biopsy was performed and showed aspergillus fumigatus. The lesion responded poorly to different antimycotic therapies, invaded the chiasma and the patient lost her visual acuity till no light perception. The third patient was treated with high doses MPS for GVHD. She presented for acute bilateral visual loss. Visual acuity was no light perception in both eyes. There was a strong anterior chamber inflammation and the fundus was hardly visible. A systemic work-up demonstrated pulmonary and brain lesions and a positive immunologic test for aspergillus. Vitreous specimen showed the presence of aspergillus. No visual acuity could be saved despite intense antimycotic treatment. Few months after, the patient died.
ConclusionOur cases illustrate that ophthalmic aspergillosis can present acutely with a devastating intraocular inflammation or more indolently in the setting of sino-orbital aspergillosis. Both forms have a bad visual prognosis and the systemic one is frequently associated with a fatal outcome.
Auteur 1
NomWILLERMAIN
InitialesF
InstitutCHU St-Pierre
VilleBruxelles
Auteur 2
NomBradstreet
InitialesC
InstitutCHU St-Pierre
VilleBruxelles
Auteur 3
NomKampouridis
InitialesS
InstitutCHU St-Pierre
VilleBruxelles
Auteur 4
NomLibert
InitialesJ
InstitutCHU St-Pierre
VilleBruxelles
Auteur 5
NomKoch
InitialesP
InstitutCHU St-Pierre
VilleBruxelles
Auteur 6
NomCaspers
InitialesL
InstitutCHU St-Pierre
VilleBruxelles
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