Acute chiasmal abscess resulting from perineural extension of invasive sino-orbital aspergillosis in an immunocompetent patient

Ilya Leyngold, Alessandro Olivi, Masaru Ishii, Ari Blitz, Peter Burger, Prem S. Subramanian, Gary Gallia

Research output: Contribution to journalReview article


Objective Intracranially invasive sino-orbital aspergillosis is a rare entity seen predominantly in immunocompromised individuals. We report a unique case of an acute chiasmal abscess resulting from perineural extension of an indolent invasive sino-orbital aspergillosis in an immunocompetent patient. Case Description A 61-year-old healthy Ukrainian man presented with severe left retro-orbital pain and a gradual ipsilateral monocular vision loss with rapid progression to a contralateral temporal visual field cut. He was found to have an intracranially invasive sino-orbital Aspergillus fumigatus infection with perineural extension along the optic nerve complicated by an acute chiasmal abscess. Results The patient was managed with surgical debridement and adjuvant antifungal chemotherapy. The patient's life and vision were preserved. Conclusions The case demonstrates that it is possible to successfully control advanced intracranial aspergillosis with tissue-sparing surgery and adjuvant antifungal chemotherapy in immunocompetent individuals.

Original languageEnglish (US)
Pages (from-to)203.e1-203.e6
JournalWorld neurosurgery
Issue number1
StatePublished - Jan 2014



  • Chiasmal abscess
  • Immunocompetent patients
  • Invasive sino-orbital aspergillosis
  • Perineural extension
  • Vision loss

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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