Invasive Sinocerebral Aspergillosis with Optic Nerve Involvement in a Young Immunocompetent Female: A Case Report
Keywords:
Invasive Aspergillosis, Voriconazole, Fungal Sinusitis, Neuro-ophthalmic Manifestations, Intracranial Fungal InfectionAbstract
We report the case of a 39-year-old immunocompetent female who presented with headache, decreased vision in the left eye, and generalized body weakness. Imaging and histopathology confirmed invasive sino-nasal aspergillosis with extension into the anterior skull base, bilateral frontal lobes, and both optic nerve. She underwent functional endoscopic sinus surgery (FESS) and bifrontal decompressive craniectomy with debulking of abscess along with IV antifungal therapy. This case highlights the aggressive nature of fungal infections even in immunocompetent individuals and the importance of early recognition and multidisciplinary management with aggressive antifungal therapy combined with timely surgical intervention in achieving optimal outcomes.
Downloads
Metrics
References
Kaul R, Sood A, Kumar R, Sharma M. Imaging features of invasive and noninvasive fungal sinusitis: a pictorial review. Insights Imaging. 2019 Oct;10(1):77. doi:10.1186/s13244-019-0760-z.
Alsulaiman HM, Elkhamary SM, Alrajeh M, Al-Alsheikh O, Al-Ghadeer H. Invasive sino-orbital aspergillosis with brain invasion in an immunocompetent pregnant patient. Am J Ophthalmol Case Rep. 2021 Sep 23;24:101210. doi: 10.1016/j.ajoc.2021.101210.
Memória Jr JR, Rufino EPL, do Rêgo Aquino PL, Guimarães Filho FV, Maranhão Neto T, Vasconcelos HKNB. Brain aspergilloma in an immunocompetent individual: a case report. Surg Neurol Int. 2020 Jul 25;11:211. doi: 10.25259/SNI_321_2020.
Phogat J, Nada M, Dahiya M, Solanki S. Sino-orbito-cerebral aspergillosis in an immunocompetent patient: a rare case report. Int J Otorhinolaryngol Head Neck Surg. 2020;6(11):2135–2138. doi: 10.18203/issn.2454-5929.ijohns20204647.
Coleman JJ, McDonald JR, McDonald TJ. Invasive central nervous system aspergillosis: a review of 14 cases. Clinical Infectious Diseases. 1997;25(5):1074-1079.
Shilpy N, Pushker N, Meel R, Agrawal S, Bajaj MS, Sharma S, Thakar A, Satapathy G, Velpandian T. Voriconazole in the treatment of invasive aspergillosis of orbit. Med J Armed Forces India. 2024 Sep-Oct;80(5):541-546. doi: 10.1016/j.mjafi.2022.08.002.
Muthu A, Madana Gopal R, Deva Sooria N. A case of invasive aspergillosis involving orbital apex and optic nerve sheath. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 2):1718–1719. doi:10.1007/s12070-021-02863-8.
Mori S, Kurimoto T, Kawara K, Ueda K, Sakamoto M, Keshi Y, Yamada-Nakanishi Y, Tachibana H, Nakamura M. The difficulty of diagnosing invasive aspergillosis initially manifesting as optic neuropathy. Case Rep Ophthalmol. 2019;10(1):11–18. doi:10.1159/000495979. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6381903/
Kourkoumpetis TK, Tsioutis C, Sipsas NV. Invasive central nervous system aspergillosis in immunocompetent hosts: a review. Infection. 2013;41(1):1-10. doi:10.1007/s15010-012-0296-7.
Downloads
Published
How to Cite
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.