Invasive Sino-orbital Aspergillosis in an Immunocompetent Host Selecting a Surgical Approach: Examining Shifting Trends

Abstract

Invasive Sino-orbital fungal infection in immunocompetent patients is a rare clinical entity; the diagnosis and management of which is challenging. Orbital fungal disease is not often suspected, because of its relative rarity and the wide range of orbital pathologies that can present similarly. Invasive aspergillosis in an immunocompetent host is a rare clinical entity. The purpose of this article is to create awareness of the existence of invasive Sino-orbital aspergillosis in an immunocompetent, young, otherwise healthy host and its management while emphasizing the importance of balancing the open surgical approach with the endoscopic approach in order to achieve the optimum clearance of disease. A 48-year-old female patient presented with 6 6-month history of nontender swelling over the left maxilla, a 5-month history of left-sided nasal blockage and a 2-month history of left orbital proptosis. Although, the endoscopic approach is widely recommended the role of the open surgical approach should not be underestimated to achieve optimum clearance. Appropriate surgical debridement should be followed by systemic antifungal agents.