Aspergillosis in the frontal sinus with intracranial extension: report of 1 case and analysis of the literature

RESUMO

The authors report a case of the 53 year old man carrier of aspergillosis in the both ethmoid and frontal sinus without association with the HIV virus. Aspergillosis in its focal and disseminated form is frequently associated with immune dysfunction, especially with patients carriers of the acquired immunodeficiency syndrome (AIDS), and it constitutes, when present in the central nervous system (CNS), a serious infection with difficult control and high morbidity index. The habitual treatment for these cases consists of the resection of the necrotic tissue and, so much as possible, of the lesions and also the administration and lingering use of liposomal amphotericin B.A lot of times, the invasion of the orbit and of the paranasal sinus can justify an aggressive conduct with extensive cranium-facial surgeries. The patient in subject was submitted to the partial resection of the lesion, which invaded the base of the anterior floor and the base of the frontal lobe to the orbitary cone and mesial face of the orbit. There was as postoperative complication, a liquoric fistula of difficult treatment due to the fragility of the dura mater in the base of the cranium infiltrated by the lesion. It received, for about 12 months, amphotericin in high doses and he comes maintaining himself stable of the clinical-neurological point of view. The authors discuss the etiopathogeny, the diagram of flow of the diagnostic and therapeutics conducts and they point out the need to include aspeergillosis of the SNC as disease of badly prognostic, deserving aggressive therapeutics in its initial phase