Rarely a patient can develop pythiosis involving the orbit. As the infection progresses it may involve cranial arteries and/or the brain.
Clinical and laboratory findings:
(1) The patient may have risk factors for pythiosis but also may be apparently healthy.
(2) The infection may infect the eye, wall of the orbit, sinuses, cranial arteries and/or brain.
(3) A biopsy shows aseptate hyaline hyphae often with eosinophils and a Splendore-Hoeppli reaction.
(4) Fungal cultures are often positive in a few days but speciation is often difficult. Molecular testing is typically faster than starndard mycotic tests.
(5) There is a poor response to systemic antifungal agents.
A case may be misdiagnosed as Mucormycosis or Aspergillosis because many clinicians are unfamiliar with Pythium insidiosum.
To read more or access our algorithms and calculators, please log in or register.
