Abstract
Invasive fungal sinusitis (IFS) is a common manifestation in immunocompromised patients. The common offenders are Aspergillus and Mucor. These fungal infections can cause various systemic complications, both intracranial and extracranial. Ultimately it may lead to fungemia and death. Very few cases of IFS caused by candida have been reported in the literature. Candida is a yeast like fungus, present normally as a commensal in the oral cavity and skin. Invasive fungal sinusitis with central retinal artery occlusion (CRAO) with candida is extremely rare. We are reporting a case of cavernous sinus thrombosis (CST) with CRAO causing bilateral blindness in a patient with invasive candida sinusitis.
Highlights
Central retinal artery occlusion (CRAO) is an ocular emergency
CRAO can occur because of infiltration of CRA by fungi from the orbit. This usually happens in the setting of cavernous sinus thrombosis (CST), which is a serious condition manifesting with headache, swelling of eyeball, ptosis, restricted ocular movements, visual loss, fever and altered sensorium
The typical clinical picture of rhinosinusitis with cavernous sinus involvement associated with stroke or vascular occlusion is highly suggestive of a fungal etiology, Aspergillus and Mucor [3, 4]
Summary
Central retinal artery occlusion (CRAO) is an ocular emergency. Patient typically presents with acute painless loss of vision which can be unilateral or bilateral. CRAO can occur because of infiltration of CRA by fungi from the orbit This usually happens in the setting of cavernous sinus thrombosis (CST), which is a serious condition manifesting with headache, swelling of eyeball, ptosis, restricted ocular movements, visual loss, fever and altered sensorium. Case report A 41-year-old gentleman, HbsAg +ve, diabetic, nonsmoker and non-alcoholic, presented with 10 days history of headache, fever, right facial swelling, nasal obstruction and running nose on a background of chronic sinusitis. As he developed ptosis, chemosis, and swelling of right eyeball in spite of a course of intravenous antibiotics, he was referred to us for further management. He was advised to continue the treatment for a minimum of 6 months under closed supervision
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