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| LETTER TO THE EDITOR |
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| Year : 2018 | Volume
: 1
| Issue : 2 | Page : 55 |
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A rare case of isolated retro-orbital fungal granuloma
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
| Date of Web Publication | 24-Apr-2019 |
Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JHNP.JHNP_16_18
How to cite this article:
Al-Mendalawi MD. A rare case of isolated retro-orbital fungal granuloma. Int J Head Neck Pathol 2018;1:55 |
Sir,
I read with great interest the case report by Kaipuzha et al.[1] published in the January–June 2018 issue of the International Journal of Head and Neck Pathology. The authors described the clinical picture, diagnostic protocol, and treatment plan of the isolated retro-orbital fungal granuloma caused by Aspergillus versicolor in an Indian patient.[1] I assume that the rare development of that fungal granuloma at an unusual site must alert the authors to consider the underlying jeopardized immunity in the studied patient. Among jeopardized immune states needed to be considered, human immunodeficiency virus (HIV) infection has the leading priority. My assumption is based on the following point. It is explicit that due to low immunity, individuals infected with HIV are more susceptible to various bacterial, fungal, and parasitic infections compared to the individuals with the healthy immune system. Among fungal infections, aspergillosis has been reported in HIV-infected patients.[2] Studying fungal infections in India showed that 34% of infections were cryptococcosis and 16% of cases were aspergillosis.[3] Interestingly, 28% of cases were immunocompetent, and 72% were immunocompromised.[3] India is facing the distressing health hazard of HIV infection. The published data pointed out to 0.26% HIV seroprevalence compared with a global average of 0.2%.[4] I assume that defining the HIV status in the studied patient through the diagnostic workup of blood CD4 lymphocyte count and viral overload estimations was solicited. If that workup was to disclose HIV positivity, the case in question could truly expand the spectrum of HIV-associated aspergillosis rarely reported in the Indian literature.[5]
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Kaipuzha RR, Pulimoottil DT, Bakshi SS, Gopalakrishnan S. A rare case of isolated retro-orbital fungal granuloma. Int J Head Neck Pathol 2018;1:28-30.  [Full text] |
| 2. | Humphrey JM, Walsh TJ, Gulick RM. Invasive Aspergillus sinusitis in human immunodeficiency virus infection: Case report and review of the literature. Open Forum Infect Dis 2016;3:ofw135. |
| 3. | Sethi PK, Khanna L, Batra A, Anand I, Sethi NK, Torgovnick J, et al. Central nervous system fungal infections: Observations from a large tertiary hospital in Northern India. Clin Neurol Neurosurg 2012;114:1232-7. |
| 4. | Paranjape RS, Challacombe SJ. HIV/AIDS in India: An overview of the Indian epidemic. Oral Dis 2016;22 Suppl 1:10-4. |
| 5. | Kaur R, Mehra B, Dhakad MS, Goyal R, Bhalla P, Dewan R, et al. Fungal opportunistic pneumonias in HIV/AIDS patients: An Indian tertiary care experience. J Clin Diagn Res 2017;11:DC14-9. |
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