Allergic Fungal Sinusitis with Bilateral Optic Neuropathy

Introduction Allergic Fungal Rhinosinusitis (AFRS) is characterized by an inflammatory response to a non-invasive fungus which leads to sinus obstruction. Ophthalmic manifestations of AFRS are rare but can be of grave consequence. Case Report A 22-year-old female patient presented with a 5-day history of headache and decreased vision in both eyes (right- perception of light; left-6/18), along with a past history of nasal blockage and recurrent rhinorrhoea. She had thick viscid mucous secretion with polyposis in bilateral nasal cavities. Computed tomography showed pansinusitis with heterogenous opacification and polypoidal mucosal hypertrophy. Bony erosion was seen in bilateral orbital apices with oedematous optic nerves. MRI was suggestive of bilateral optic neuritis. Patient underwent emergency surgical debridement via endoscopic sinus surgery. Histopathological examination of the specimen showed cellular debris, eosinophilic prominence and numerous Charcot-Leyden crystals, with presence of branched septate fungal hyphae. Fungal culture grew Aspergillus flavus. Patient was treated with steroids (injectable followed by oral in gradually tapering doses). Over a period of 3 months vision returned to normal. Conclusion Vision loss is a rare complication of AFRS and constitutes an emergency. Prompt treatment with surgical debridement and corticosteroids is essential for reversal of visual complications

Button cell battery as foreign body ingestion in children: A retrospective analysis in a tertiary care center

Abstract—Button cell foreign bodies are increasingly presented as foreign bodies in esophagus. Many a time no positive id on button cell and can be mistaken as foreign body coin and delayed for management. Retrospectively analyze of 19 admitted cases with foreign body ingestion in children for foreign body Lithium ion battery button cell in esophagus done with the aim to evaluate epidemiology, clinical presentation and duration of presentation, radiological findings, endoscopic findings and complications in such cases. Clinical record of patients with foreign body Button cell batteries was reviewed and compiled in Microsoft Excel sheet and descriptive and percentage analysis was done. There were 11 (57.89%) male patients and 8 female patients. History of foreign body battery cell was given by the parents of 10 children. 3 patients presented with respiratory complains. After history and radiological examination in 17 out of 19 patients presence of lithium cell battery was suspected prior to endoscopic removal. In 4 patients severe mucosal injury noted. It was concluded from this study that foreign body button cell can cause serious injuries to upper aerodigestive tract. These should be promptly removed