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November 1991

Primary Aspergillosis of the Orbital Apex

Author Affiliations

New Hyde Park, NY

Arch Ophthalmol. 1991;109(11):1502-1503. doi:10.1001/archopht.1991.01080110036024

Aspergillus fumigatus is an opportunistic fungal pathogen that typically affects the pharynx and paranasal sinuses with secondary orbital involvement.1 Primary orbital (and central nervous system) involvement with aspergillosis has been reported infrequently.2 In some cases, an erroneous diagnosis of idiopathic orbital inflammation may be made and the early use of high dosages of corticosteroids may result in disaster.

Report of a Case.  —A 65-year-old man with atherosclerotic heart disease developed left-sided headaches and brow ache in December 1988. One month earlier, he was noted to have shingles of the left buttock. Diplopia ensued in January 1989, and results of magnetic resonance imaging were stated to be normal.At the time of the neuro-ophthalmologic examination 1 month later, the patient complained of severe left retro-orbital pain and diplopia. A left motility disturbance with 90% of normal adduction, 40% infraduction, 0% supraduction, and 50% abduction was detected. There was marked

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