안와 및 두개내로 파급된 침윤성 국균증: 보리코나졸로 치료한 1예

• 영문명: A Case of Invasive Aspergillosis Involving the Orbital Apex and Occipital Lobe:Successful Treatment with Voriconazole
• 발행기관: 대한안과학회
• 저자명: 임선희 성순희 임기환,Sun Hee Lim, MD, Sun Hee Sung, MD, PhD, Key Hwan Lim, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume54,number3, 540~544쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2013.03.15

영문 초록

Purpose: To report an immunocompetent patient with more than 1-year survival after treatment with voriconazole, despite invasive paranasal sinus aspergillosis involving the orbital apex. Case summary: A 74-year-old woman with only preexisting hypertension visited our clinic complaining of pain and immovable left eye that occurred approximately 4 days prior. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a sphenoid sinusitis with suspicious lesion involving the orbital apex of the left eye. A biopsy by functional endoscopic sphenoid surgery (FESS) was performed through the sphenoid sinus, which enabled us to diagnose aspergillosis. The patient had esotropia, ophthalmoplegia, positive RAPD, and ptosis in the left eye. On follow-up, a new MRI showed acute to subacute stage infarction at the left occipital lobe. After the patient was treated with intravenous voriconazole, ptosis, and ophthalmoplegia improved. At the 13-month follow-up, she was alive with no disease recurrence. Conclusions: Invasive aspergillosis of orbit and cerebrum in healthy patients is a rare clinical entity. In case of central nervous system involvement, the survival outcome is poor with high mortality; however, good results can be obtained by treatment with voriconazole.

키워드

Immunocompetent patient, Invasive aspergillosis, Orbital apex, Voriconazole