Acute invasive fungal rhinosinusitis in pediatric patients with oncohematological diseases

Rodrigues, Lorrane Caroline Braga; Guimaraes, A F; Oliveira, Isamara Simas de; Sousa, Pedro Henrique Medici de; Romanelli, Roberta Maia de Castro; Kakehasi, Fabiana Maria; Rodrigues, Karla Emília de Sá

doi:10.1016/j.htct.2020.08.016

Cited by 6 publications

(2 citation statements)

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“…The recovery of the absolute neutrophil count to normal levels in parallel with systemic antifungal therapy and surgical debridement of tissues is essential to improve survival. There is no specified treatment time frame reported in the literature, but rather the emphasis of initiating treatment until other factors contributing to the infection are adequately controlled, as well as clinical and microbiological improvement ( 25 , 26 ). Various approaches have been described for surgical debridement, from the more traditional lateral rhinotomy including exenteration when indicated, to fully endoscopic techniques ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Pediatric invasive fungal rhinosinusitis

et al. 2023

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Pediatric invasive fungal rhinosinusitis (PIFR) is a rapidly progressive, potentially fatal disease. Previous medical literature demonstrates that its early diagnosis significantly reduces the risk of mortality in these patients. This study aims to present an updated clinical algorithm for optimized diagnosis and management of PIFR. A comprehensive review was conducted with only original, full-text articles published in English and Spanish from Cochrane Library, Pub-Med/MEDLINE, Embase, Scopus, and Google Scholar between January 2010 and June 2022. Relevant information was extracted and then integrated to develop a clinical algorithm for a proper diagnosis and management of PIFR.

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Section: Discussionmentioning

confidence: 99%

Pediatric invasive fungal rhinosinusitis

et al. 2023

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“…AIFRS is largely attributable to Aspergillus and Mucorales [ 1 ]; albeit other atypical fungal pathogens, such as Fusarium spp. [ 5 , 6 , 7 ] and dematiaceous fungi [ 6 , 7 , 8 ], have been rarely described as disease-etiological agents and have been associated with worse survival [ 6 ]. We herein report the first case in Europe of acute necrotizing invasive FRS caused by Alternaria alternata in a patient with acute lymphoblastic leukemia (ALL).…”

Section: Introductionmentioning

confidence: 99%

Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by Alternariaalternata in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review

Tyrellis

Siopi

Leventakou

et al. 2022

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Alternaria spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by Alternaria alternata, is reported in a patient with acute lymphoblastic leukemia (ALL) on anidulafungin therapy, who was successfully treated with liposomal amphotericin B and surgical intervention. To date, 20 cases of AIFRS due to Alternaria spp. have been described, 19 in the USA and 1 in Chile, making this case report the first case of AIFRS due to Alternaria in Europe. The patients had median (range) age 25 (2–56) years (65% female), almost all of them (19/20) with hematological diseases and severe neutropenia (8–41 days pre-infection). Amphotericin B was the most frequently used antifungal agent, either alone or in combination. In all of the cases, systemic antifungal therapy was combined with surgery. Despite stabilization or improvement of the AIFRS, mortality was 38% (5 days to 8 months post-surgical debridement) due to their underlying disease or other infections without sign of AIFRS at autopsy.

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