DR. ADITI JHUNJHUNWALA

DR. RAMYASH SINGH YADAV, DR. CHIRANJI RAI

Abstract

We present a very rare case of fungal orbital cellulitis which presented to us as a pus discharging fistula below medial canthus. Patient presented with signs of orbital cellulitis along with a pus discharging fistula below medial canthus with positive mucopurulent discharge from puncta and fistula on syringing. It started with swelling near medial canthus. Patient responded well on broad spectrum antibiotics but developed necrotic patch on hard palate. MRI showed intraconal and extraconal involvement. Diagnostic Nasal Endoscopy (DNE) was done and tissue sent for KOH mounting, culture and histopathology. After KOH mount showed budding like yeast cells patient was started on antifungals and discharged when repeat culture report showed no growth. Therefore, a high level of suspicion should be maintained for fungal cause even in the presence of the pus discharging fistula.