{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:35:53Z","timestamp":1781177753242,"version":"3.54.1"},"reference-count":35,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Invasive aspergillosis is a rare but severe fungal infection primarily affecting immunocompromised individuals. The Coronavirus Disease-2019 (COVID-19) pandemic has introduced new complexities in managing aspergillosis due to the widespread use of corticosteroids for treating COVID-19-related respiratory distress, which can increase susceptibility to fungal infections. Here, we present a challenging case of progressive cerebral aspergillosis complicated by cavernous sinus thrombosis (CST) in a 67-year-old male with a history of COVID-19. The patient, initially misdiagnosed with temporal arteritis, received pulse corticosteroid therapy twice before presenting with persistent left-sided headaches and vision loss. Cranial imaging revealed findings consistent with fungal sinusitis, Tolosa\u2013Hunt syndrome, and orbital pseudotumor, which progressed despite initial antifungal therapy. Subsequent magnetic resonance imaging indicated an invasive mass extending into the left cavernous sinus and other intracranial structures, raising suspicion of aspergillosis. A transsphenoidal biopsy confirmed Aspergillus infection, leading to voriconazole therapy. Despite aggressive treatment, follow-up imaging revealed significant progression, with extension to the right frontal region and left cavernous sinus. The patient then developed visual impairment in the right eye and was diagnosed with CST secondary to fungal sinusitis. Management included a combination of systemic antifungals and antibiotics; however, the patient declined surgical intervention. This case underscores the diagnostic challenges and rapid progression associated with cerebral aspergillosis in post-COVID-19 patients treated with corticosteroids. This report highlights the need for heightened clinical suspicion and prompt, targeted interventions in similar cases to improve patient outcomes. Further research is required to understand the optimal management of invasive fungal infections.<\/jats:p>","DOI":"10.3390\/jof10110788","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T06:23:16Z","timestamp":1731478996000},"page":"788","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Invasive Aspergillosis with Cavernous Sinus Thrombosis Following High-Dose Corticosteroid Therapy: A Challenging Case of Rhino-Orbital-Cerebral Mycosis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7368-7187","authenticated-orcid":false,"given":"Faruk","family":"Karake\u00e7ili","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-7740","authenticated-orcid":false,"given":"Or\u00e7un","family":"Barkay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bet\u00fcl","family":"S\u00fcmer","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3841-9109","authenticated-orcid":false,"given":"Umut Devrim","family":"Binay","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Infectious Diseases and Clinical Microbiology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6746-3906","authenticated-orcid":false,"given":"Kemal Bu\u011fra","family":"Memi\u015f","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Radiology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zlem","family":"Yap\u0131c\u0131er","sequence":"additional","affiliation":[{"name":"Medical Pathology Department, Bah\u00e7e\u015fehir University Medicine Faculty Hospital, \u0130stanbul 34349, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mecdi G\u00fcrhan","family":"Balc\u0131","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pathology Department, Erzincan Binali Y\u0131ld\u0131r\u0131m University, Erzincan 24100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s12281-022-00434-0","article-title":"Overview of COVID-19-Associated Invasive Fungal Infection","volume":"16","author":"Shishido","year":"2022","journal-title":"Curr. 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