DR. ANKITA GOGOI

DR. PANKAJ BARUAH, DR. PAYAL SINGLA, DR. MANJIT BORO

Abstract

A 38 year male presented with sudden onset loss of vision L/E for 3 months associated with nasal blockage and discharge, deviation of angle of mouth & headache. No prior/current covid infection. O/E: soft, shrunken PL negative L/E with total ophthalmoplegia L/E, drooping associated with vascularised total corneal opacity L/E was seen. R/E: WNL with VA: 6/6.Patient is diabetic (recently diagnosed) on OHA,with well-controlled glycemic status.HbA1c: 5.85%,RBS: 168mg/dl. MRI showed Near total opacification of all paranasal sinuses with increase in soft tissue in left cavernous sinus with occlusion of internal carotid artery and decreased left globe size. KOH mount and calcofluor stain of nasal swab showed aseptate fungal filaments. Diagnosis of rhino-orbital fungal infection with CST was made. After ENT, Neurology consultation, patient was started on liposomal amphotericin B and underwent FESS f/b enucleation of L/E. Patient improved and was later planned for anticoagulant therapy for CST