Reversible neuropraxic visual loss induced by allergic Aspergillus flavus sinomycosis.

This work reports a patient with visual loss treated successfully with surgical removal of the Aspergillus flavus sinomycosis. Vision was partially reversed within hours after surgery before starting planned corticosteroid therapy. The patient's visual acuity continued to improve steadily until it became equal to that of the other eye. The immediate gain in vision and continued improvement without corticosteroid therapy suggest a new hypothesis for visual loss induced by allergic sinonasal Aspergillosis. Simple mechanical pressure alone of the aspergillus mass over the nerve can produce visual loss, and this loss is reversed by removing the mass without corticosteroid therapy.

Otitis externa malignant. A case report and review of literature.

Otitis externa malignant (OEM) is a virulent infection if it is not diagnosed and treated promptly. Its mortality rate was reported to be 53% when there is associated facial nerve paralysis. It usually affects elderly diabetic patients, who present with deep-seated pain and other features of non-resolving otitis externa. It is mostly caused by Pseudomonas (P) aeruginosa and the treatment of choice is anti-Pseudomonas antibiotic. A 64-year-old diabetic male patient is described who presented with left ear pain and discharge for two months and did not respond to ordinary treatment. The patient also noticed a progressive facial weakness on the same side. The clinical presentation, investigations, treatment and follow-up of the OEM are discussed on the basis of our case and the review of the literature. The diagnosis of OEM is based on high index of suspicion and confirmed by histopathologic changes and radionuclide studies. Gallium 67 citrate scan is a sensitive way to diagnose and follow up the regression of the disease in response to the medical treatment. Ciprofloxacin is the treatment of choice; however, it has to be in accordance to culture and sensitivity results.