Invasive Fungal Sinusitis Involving the Orbital Apex in a Patient with Chronic Renal Failure.

An 82-year-old man with chronic renal failure presented with invasive fungal sinusitis involving the right orbital apex. Intravenous liposomal amphotericin B was immediately administered with an intravenous sodium supplement. Subsequently, endoscopic sinus surgery was performed. Aspergillus fumigatus was detected in nasal discharge culture on day 12. Because the patient's renal function had deteriorated by this time, therapy was changed to nasal inhalation of amphotericin B, which was discontinued after 1 month, and oral administration of voriconazole, which was discontinued after 2 months. During 6-month follow-up, the patient did not show recurrence of sinusitis or further decrease in renal function.