Complications

Complication
Timeframe
Likelihood
short term
medium

Caused by occlusion of the central retinal artery by fungal invasion. The damage is irreversible. If the orbit is involved, treatment includes enucleation.

variable
high

Tubular toxicity leads to electrolyte imbalance such as hypokalaemia, hypomagnesaemia, and hypocalcaemia. Use of liposomal or lipid formulations minimise renal dysfunction and toxicity.[12]

variable
medium

Proliferation of the spores after invasion of the vasculature produces hyphae. These hyphae subsequently erode the vascular endothelium, leading to thrombosis and tissue infarction.[78] These inflammatory events cause thrombosis of cavernous sinus and internal carotid artery.

variable
medium

Thrombosis of cerebral vessels causes tissue necrosis resulting in abscess formation. Usual symptoms include focal deficits and seizures. Treatment is surgical drainage and prolonged medical therapy.

variable
low

Ophthalmoplegia associated with significant eye pain, proptosis, chemosis, and headache signifies likely presence of cavernous sinus thrombosis. Early medical and adequate surgical therapy is essential. Role of anticoagulation is controversial.

variable
low

Occurs due to development of mycotic aneurysm or fungal abscess. These can lead to subarachnoid haemorrhage and intracranial haematoma.[79]

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