FP387 : Jacod syndrome –fungal etiology on the rise

Ms.Minu sasikumar

Prospective caseseries from march2016-may2017Including patients presenting with acute onset of total ophthalmoplegia.Exclusion criteria:congenital orbital wall disorders,Preexisting orbital disease,CPEO,previously diagnosed cases of cavernous sinusthrombosis,orbital cellulitis,recent h/otrauma,h/o myasthenia.PROCEDURE:12 patients with orbital apex syndrome evaluated.All Routine blood investigations&imaging done.FESS sample sent for h/p based on which treatment was initiated•RESULTS:8 patients FESS(66%)done.Orbital decompression in only 4 patients(33%)–only 1showed ophthalmoplegia resolution following procedure.FESS specimen sent for h/p showed equal incidence of mucor and asper ie100%fungal etiology.5started on amphotericin b,5on triazole.All pts with mucor died.3of12 patients who survived 2diagnosed with pseudotumour 1with asper.75%were diabeticof which 6 were uncontrolled•CONCLUSION:Study highlights escalating fungal etiology for jacod with 100%FESS samples showing fungal etiology