Fungus That Struck the Brain: A Case of Invasive Sino-Orbital Aspergillosis Causing a Stroke

Invasive sino-orbital aspergillosis is a rare but potentially fatal fungal infection that predominantly affects immunocompromised individuals. It can lead to severe complications such as internal carotid artery invasion and ischemic stroke. We report a case of a 74-year-old male patient with uncontrolled diabetes mellitus who presented with right eye pain and proptosis. Imaging revealed a sino-orbital mass with invasion into the cavernous sinus and internal carotid artery. Following a biopsy, the patient suffered an ischemic stroke due to the right internal carotid artery occlusion, requiring mechanical thrombectomy and stent placement. Histopathology confirmed <i>Aspergillus fumigatus</i>, and the patient was treated with amphotericin B and voriconazole, showing improvement. This case highlights the importance of early diagnosis and a multidisciplinary approach in managing invasive sino-orbital aspergillosis to prevent fatal vascular complications.