Primary orbital aspergillus infection may occur in immunocompetent individuals. It frequently represents a diagnostic challenge for clinicians due to nonspecific clinical presentations and neuroimaging signs. We present a 47-year-old otherwise healthy man with an isolated unilateral optic neuropathy secondary to primary orbital aspergillosis. He had a remote history of tuberculosis and positive syphilis serologies. After he worsened despite intravenous penicillin therapy, a biopsy showed chronic inflammation. Corticosteroids treatment was followed by further deterioration of his clinical condition. Finally, a repeat biopsy revealed the aspergillus infection. Despite antifungal therapy, the outcome was unfavorable. A high index of suspicion should result in aggressive diagnostic testing and prompt institution of antifungal therapy in patients with primary orbital aspergillosis.
Bibliographical noteFunding Information:
The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article. Publication of this article was supported by unrestricted grants from Research to Prevent Blindness, New York, NY, and the Lions Club of Minnesota.
- Antifungal therapy
- Aspergillus infection
- Primary orbital Aspergillosis