Lower eyelid aspergillosis infection mimicking a pyogenic gr
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A 34-year-old pregnant woman presented with a pigmented mass in her left lower eyelid for the past 2 weeks (figure 1). The patient was at 7 months of gestational age. On examination, she was alert, conscious with stable vitals. There was no evidence of any fever, pallor or icterus. On ocular examination, visual acuity in both eyes was 6/6, with intraocular pressure of 12 mm Hg and 14 mm Hg in the right and the left eye, respectively. There was a large pigmented mass on the left lower eyelid measuring 16×12?mm, along with mechanical ectropion of the lower lid. On slit lamp examination, there was left palpebral conjunctival congestion adjacent to the mass. Rest of the anterior segment and posterior segment examination of both eyes were within normal limits.

Based on the appearance, a provisional diagnosis of left eye lower eyelid pyogenic granuloma was made and the patient was planned for excision biopsy of the lesion. The biopsy was performed, and the lesion was removed. Histopathological examination of the lesion revealed septate hyphae suggestive of aspergillosis. However, the removed mass was not sent for microbiological studies. At the 3-week follow-up, the patient did not have any evidence of recurrence.

Aspergillus is a ubiquitous fungus found particularly in the soil and decaying vegetation.There are four main types of Aspergillus: Aspergillus fumigatus, A. flavus, A. lentulus and A. nidulans. A. fumigates and A. flavus are the most common fungal contaminants of the sinuses and have the potential to infect the orbit. Even healthy individuals are at risk of sino-orbital aspergillosis. However, it is more seen in immunocompromised hosts. A pregnant woman has a predisposition to individual microorganisms, depending on how the immune response of her fetoplacental unit behaves.4 It is a distinctive immunological state, making the individual vulnerable to a specific set of infectious diseases and resistant to others.

Source:https://casereports.bmj.com/content/13/12/e238732
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