Orbital granulomatosis with polyangiitis masquerading as invasive fungal sinusitis

Orbit. 2018 Aug;37(4):309-312. doi: 10.1080/01676830.2017.1423339. Epub 2018 Jan 5.

Abstract

A 55-year-old man presented with unilateral orbital inflammation and no light perception vision. Imaging revealed infiltrative enhancement of the optic nerve, orbit, and intracranial tissue. The case was suspicious for invasive fungal disease, but ultimate workup and orbital biopsy revealed granulomatosis with polyangiitis. The patient's inflammation resolved with corticosteroid and rituximab therapy. Granulomatosis with polyangiitis is a systemic vasculitis that can mimic a number of orbital pathologies.

Keywords: Orbital; granulomatosis; polyangiitis.

Publication types

  • Case Reports

MeSH terms

  • Aspergillosis / diagnosis*
  • Aspergillosis / microbiology
  • Aspergillus flavus / isolation & purification
  • Biopsy
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Eye Infections, Fungal / diagnosis*
  • Eye Infections, Fungal / microbiology
  • Glucocorticoids / therapeutic use
  • Granulomatosis with Polyangiitis / diagnosis*
  • Granulomatosis with Polyangiitis / drug therapy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Orbital Diseases / diagnosis*
  • Orbital Diseases / drug therapy
  • Orbital Diseases / microbiology
  • Rituximab / therapeutic use
  • Sinusitis / diagnosis*
  • Sinusitis / microbiology

Substances

  • Glucocorticoids
  • Rituximab