Korean J Otorhinolaryngol-Head Neck Surg.  2015 Jan;58(1):52-56. 10.3342/kjorl-hns.2015.58.1.52.

A Case of Aspergillus Clival Abscess Treated by Endoscopic Removal

• Kim JS
• Jang KS
• So YK
• Hong SD

• KMID: 2277932
• DOI: http://doi.org/10.3342/kjorl-hns.2015.58.1.52

Abstract

Aspergillus clival abscess, especially without a sphenoid sinus lesion, is a very rare infection of central nervous system. In this report, we describe the successful treatment of a patient with aspergillus clival abscess. A 63-year-old man was referred to our hospital with the diagnosis of sphenoid mass lesion in magnetic resonance image accompanied by headache and diplopia. The computed tomography scan revealed a clival cystic lesion without connection with the sphenoid sinus. The patient underwent the endoscopic endonasal clival approach and histopathological examination revealed aspergillosis. Postoperatively, the patient was given IV amphotericin-B for 2 weeks and oral voriconazole for 3 months. After surgery, patient's headache and diplopia disappeared. Aspergillus abscess originating from the skull base is rare but has a high mortality rate. Histopathological confirmation via endonasal approach and intensive antifungal therapy should be started for a successful treatment.

Keyword

Aspergillosis; Clivus; Endoscopy

MeSH Terms

Abscess*
Aspergillosis
Aspergillus*
Central Nervous System
Cranial Fossa, Posterior
Diagnosis
Diplopia
Endoscopy
Headache
Humans
Middle Aged
Mortality
Skull Base
Sphenoid Sinus