Invasive Aspergillosis in an Immunocompetent Asian Teenager
Case Report
A 19-year-old male, with a 6-month history of gradually enlarging fluctuant mass approximately 8 × 8 mm in size was noted inferior to the lower eyelid on the left maxillary area with associated pain (4/10, non-radiating), erythema, rupturing spontaneously with bloody and purulent discharge. He consulted a local doctor after the spontaneous rupture of mass, which, as reported, did not cause the mass to shrink and was treated as a case of preseptal cellulitis and was given coamoxiclav 625 mg/tab TID for 7 days with no improvement. Another consultation was done 2 months later due to gradual increase in size and non-resolution of above mentioned symptoms, with development of facial numbness with intermittent episodes of pain, gradual proptosis and blurring of vision of the left eye. Extraocular movement was reportedly still full with no note of diplopia. He was diagnosed to have an abscess and was again treated with co-amoxiclav 625 mg/tab TID for 7 days, still with no improvement of symptoms. On follow-up, 5 months after the onset of symptoms, no improvement was noted and the blurring of vision of the left eye with proptosis worsened. MRI of the orbit and sinuses was performed for further management.

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