Abscesso intraorbitário e intracraniano por Aspergillus fumigatus

Orbital and cranial abscess by Aspergillus fumigatus

RESUMO

Os autores relatam um caso raro de infecção por Aspergillus fumigatus do sistema nervoso central, secundário a infecção intraorbitária, em um paciente de 12 anos que sofreu ferimento penetrante em região infraorbitária esquerda por estilete de madeira. Foi submetido a 3 craniotomias sequenciais, sendo apenas possível remoção parcial dos abscessos e do fragmento de madeira.

O paciente evoluiu com amaurose bilateral, oftalmoplegia e proptose esquerda, Diabetes insipidus e hidrocefalia. Foi submetido a derivação ventrículo peritoneal e controlada a Diabetes insipidus com DDAVP. Após um mês teve alta em regular estado geral com déficits descritos.

São discutidos a patogenicidade, vias de infecção, diagn6stico e tratamento, baseados em dados colhidos da literatura em pacientes infectados por Aspergillus sp..

Palavras-chave:
Aspergillus; Proptose; Amaurose; Fragmento de madeira

SUMMARY

Aspergillus infections involving the orbit and the CNS is a rare pathology. We present one case of a 12 years old male who suffered a penetrating injuring with a piece of wood at the level of the lower lid. CT scan reveled a hyperdense area with irregular lesion at the medial position of the orbit and invading the supra-se-lar and parasselar region. The patient was submitted to 3 craniotomies and clinically treated with Anfotericin B and Rocefin (Ceftriaxona). A review of the literature was done.

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Datas de Publicação

• Publicação nesta coleção
  Mar-Apr 1990