A rare case of isolated retro-orbital fungal granuloma

Abstract

We report here the first case of retro-orbital fungal granuloma caused by Aspergillus versicolor. A 52-year-old male presented with protrusion of left eye associated with pain in the left eye and watering of the left eye for 6 months duration. Left eye examination showed axial proptosis, and fundus examination revealed blurring of the nasal disc margin. Diagnostic nasal endoscopy revealed an irregular pinkish proliferative mass medial to the middle turbinate. Plain computed tomography of the orbits showed a retrobulbar intraconal lesion in the left orbit. The patient was taken up for endoscopic orbital and optic nerve decompression with debulking or retro-orbital mass under general anesthesia. Culture on Sabouraud's dextrose agar grew Aspergillus species. The patient was started on oral itraconazole 100 mg twice daily, and over the course of 2 months, the left eye proptosis reduced significantly. Review at 2 years postoperatively did not reveal any recurrence of symptoms. Endoscopic clearance of the disease combined with oral antifungals is the appropriate modality of therapy for aspergillosis.

Keywords

• aspergillus versicolor
• fungal
• proptosis
• retro-orbital granuloma