Fungal infections of the orbit: The present scenario in a developing country

Authors : Rachna Agarwal, Shabari Pal, Kumudini Sharma, Vaibhav Kumar Jain, Prabhakar Mishra

DOI : 10.18231/j.ijooo.2021.010

Volume : 7

Issue : 1

Year : 2021

Page No : 49-54

Introduction: Fungal infections of the orbit have been recognized as one of the most critical infective lesions in the field of ophthalmology due to its morbidity, its association with blindness and even mortality. Delayed presentation and nonspecific symptoms present peculiar challenges in diagnosis and management to the ophthalmologist. This descriptive retrospective study was done to characterize fungal infections of orbit in terms of demographic variables and associated risk factors as well as to describe the clinical spectrum and outcomes of the disease.
Materials and Methods: The study is a retrospective, clinicopathological analysis of invasive fungal orbital disease presenting at a tertiary care multi-speciality centre. Data collected included demographic details as well as any medical or surgical morbidities, ongoing treatment, clinical examination findings which included detailed ophthalmologic examination, findings of routine investigations as well as HIV serology, orbital and neuro imaging reports. Treatment outcome details were also recorded from medical follow up records.
Results: 20 cases of fungal infections of orbit due to microbiologically confirmed mucormycosis or aspergillosis were identified during this period. Continuous data was presented in median (interquartile range) and categorical data was represented in frequency (%). Mann Whitney u test was used for continuous data and Fischer exact test was used to compare proportions. Patients with mucor mycosis had higher mortality (53.3%) than aspergillosis (25%). Extension to brain, haematological malignancy and AIDS are negative prognostic factors.
Conclusion: Orbit involving mucormycosis infection is more common and has higher mortality than aspergillosis. Late presentation is more common in developing countries.

Keywords: Fungal infections, Ocular motility disorders, Orbital disease.


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