• Marc C Peden, Arvind Neelakantan, Christine Orlando, Shahab A Khan, Alan Lessner, and M Tariq Bhatti.
• Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Florida, USA.
• Surv Ophthalmol. 2008 Nov 1;53(6):631-5.

AbstractA 52-year-old, immune-suppressed man presented with painful proptosis. Orbital imaging revealed enhancement of his right inferior rectus muscle and mild ethmoidal sinus disease. Sinus washings and turbinectomy demonstrated Curvularia. Despite aggressive intravenous antimicrobials, the patient remained febrile. Repeat imaging demonstrated a well-defined intramuscular abscess without contiguous orbital or paranasal involvement. Following surgical drainage, the patient improved. Cultures of the material expressed from the abscess confirmed a co-infection with Fusarium. Although rare, fungal abscess of the extraocular muscle should be considered in patients (particularly if immunosuppressed) with extraocular muscle enlargement resistant to conventional antimicrobial therapy. Prompt diagnosis and treatment could potentially prevent further serious morbidity or mortality.

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