Clinical approach to ophthalmoplegia in renal transplant recipients differential diagnosis and case illustration.

A 57 year-old man presented six months after undergoing renal transplantation with the orbital apex syndrome comprising of retro-orbital pain, visual loss and complete ophthalmoplegia. Pathological examination from the granulomatous-like mass in the apex of the right orbit showed branching hyphae with the characteristic appearance of aspergillus. The differential diagnosis of such a lesion in an immunocompromised patient is discussed.