ABSTRACT

This study described the clinical presentations and proposed a diagnostic algorithm of fungal orbital infections based on 20 years of experience in a tertiary eye care center in Egypt.

Method

Medical Records of cases with orbital fungal infection from January 2000 to December 2019 were reviewed.

Results

The study included 45 patients. Mucormycosis was proven in 32 (71.1%) and aspergillosis in 13 (28.9%) patients. Thirty-five (77.8%) patients had predisposing factors mainly uncontrolled diabetes. Twenty-seven (60%) patients presented with orbital apex syndrome, 10 (22.2%) with orbital cellulitis and 8 (17.7%) with proptosis. The prognosis was generally poor (31.1% mortality, 8.88% exenteration and 11.1% self-evisceration). The proposed algorithm composed of six atypical clinical presentations mainly acute orbital apex and fulminating orbital cellulitis plus any radiological or microbiological findings.

Conclusion

The proposed algorithm markedly reduced the complications after 5 years of the study. Once fungal orbital infection is suspected, treatment should start immediately.

中文翻译：

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埃及三级眼科护理中心 20 年经验后拟议的眼眶真菌感染诊断算法

摘要

本研究描述了临床表现，并根据埃及一家三级眼科护理中心 20 年的经验提出了眼眶真菌感染的诊断算法。

方法

回顾了 2000 年 1 月至 2019 年 12 月眼眶真菌感染病例的病历。

结果

该研究包括 45 名患者。32 例 (71.1%) 患者被证实为毛霉菌病，13 例 (28.9%) 患者被证实为曲霉病。35 名 (77.8%) 患者的易感因素主要是未控制的糖尿病。27 名 (60%) 患者出现眼眶尖综合征，10 名 (22.2%) 患者出现眼眶蜂窝织炎，8 名 (17.7%) 患者出现眼球突出。预后普遍较差（31.1% 死亡率，8.88% 清肠和 11.1% 自取内脏）。拟议的算法由六种非典型临床表现组成，主要是急性眼眶尖和暴发性眼眶蜂窝织炎以及任何放射学或微生物学发现。

结论

经过 5 年的研究，所提出的算法显着减少了并发症。一旦怀疑眼眶真菌感染，应立即开始治疗。