DR.DR. BHAGYATA RAI

DR. VIRNA SHAH

Abstract

48 year old immunecompetent man presented to neuro-ophthalmology OPD with headache and severe pain on right side of face. No systems illnesses.His bcva was 6/12 in RE & 6/6 in LE. Clinical examination revealed RE-corneal epitheliopathy, absent corneal sensation and restricted abduction. Neuroimaging revealed Meckel’s cave lesion(1×0.8x1cm)extending along all 3 divisions of trigeminal nerve.CSF analysis & biopsy revealed necrotising granulomatous inflammation and fragmented fungal filaments. HPE was suggestive of aspergillus granuloma.After neurologist treatment with antifungals, at one month follow up, patient had no pain.Cranial cerebral aspergillosis is a rare phenomenon in immune competent individuals and therefore mandates detailed study and evaluation. Timely intervention by combined approach of neurologists and neuro-ophthalmologist is instrumental in saving vision and life of such patients.