On November 26, a representative of Thu Duc General Hospital (Ho Chi Minh City) announced that they had successfully treated and saved a patient suffering from acute invasive fungal infection with life-threatening complications.
Life-Threatening Condition After Headache, Nasal Congestion
The patient, Ms. S. (50 years old, residing in Tam Binh ward, Ho Chi Minh City), had been living with type 2 diabetes for many years but failed to control her blood sugar well, leading to a progressive weakening of her body.
In late July, she began experiencing headaches, nasal congestion, swelling, and pain around her left eye, accompanied by blurred vision. Initially, the woman thought she had common sinusitis and self-medicated at home, but her condition did not improve; instead, it worsened.
When her eyelid became severely swollen, her left eye slightly protruded, and she experienced intense pain, her relatives took her to Thu Duc General Hospital for emergency treatment.
Upon admission, doctors noted the patient’s left eye was edematous, ptotic, with restricted eye movement, pain upon pressing the orbit, and significantly reduced vision. Through nasal endoscopy, doctors discovered areas of the mucous membrane showing signs of dry necrosis – a characteristic symptom of dangerous invasive fungal infection.
Imaging results confirmed that the patient had polysinusitis suspected to be due to invasive fungus, which had spread to the orbit and nerves. This is an extremely dangerous condition that can lead to blindness or even threaten life if not treated promptly.
The treatment team immediately convened a multidisciplinary consultation, including doctors from the Ear-Nose-Throat, Ophthalmology, Endocrinology, and Neurology departments. After a comprehensive assessment, the doctors decided on urgent surgery to debride necrotic tissue and control the infection.
The endoscopic sinus surgery lasted nearly 4 hours. During the procedure, doctors enlarged the sinuses, removed all fungal plaques, completely excised necrotic tissue from the left orbital area, and cauterized the obstructed anterior ethmoidal artery.
Doctors performing endoscopic surgery to treat fungal sinusitis complications for a patient.Doctors perform endoscopic surgery to address fungal sinusitis complications for the patient (Photo: Hospital provided).
After surgery, the patient received intravenous antifungal treatment and intensive blood sugar control with insulin. Thanks to timely intervention and close monitoring, the patient’s periorbital swelling and pain significantly decreased, the surgical wound healed well, was clean, and there was no further spread of necrosis.
Although her vision did not improve (the patient had been counseled about this before surgery), the woman no longer had ptosis, and her eyeball movement returned to normal. Subsequent histopathology results confirmed the woman had an invasive fungal infection.
A Warning for Diabetes Patients
Dr. Duong Van Ta, Head of the Ear-Nose-Throat Department at Thu Duc General Hospital, shared that acute invasive fungal sinusitis with orbital complications is a severe, rapidly progressing disease with a high prevalence of comorbidities and a high mortality rate.
Fungus invading from the nose and sinuses can spread to the orbit, leading to eye damage such as ocular palsy, proptosis, and decreased vision.
Early clinical diagnosis and suspicion in high-risk groups (such as diabetes patients), timely surgical intervention, and systemic antifungal therapy are crucial factors in improving vision and saving patients’ lives.
Ms. S.’s case serves as an important warning for people with diabetes. Poor blood sugar control not only affects the quality of life but can also pave the way for many serious complications, including invasive fungal sinusitis.
Experts recommend that when unusual signs such as persistent headaches, nasal congestion, or pain and swelling around the eyes appear, people should not be complacent but should seek medical attention immediately for timely diagnosis and treatment to avoid unfortunate consequences.
