Acute invasive fungal rhinosinusitis: our experience with 19 patients

Abstract

Acute invasive fungal rhinosinusitis (AIFR) is a potentially fatal infection that affects immunocompromised patients. Early diagnosis and treatment, including aggressive surgical debridement, antifungal medication, and correction of underlying predisposing factors are essential for recovery. The aim of this study was to review our experience with AIFR. The records of 19 patients histopathologically diagnosed with invasive fungal rhinosinusitis were retrospectively reviewed. Demographic data, presenting symptoms and signs, underlying diseases, and outcomes of the patients are presented and invasive fungal rhinosinusitis is discussed in light of the current literature.

Pathology of Fungal Rhinosinusitis: A Review

“…Acute invasive FRS is a devastating form of sinonasal fungal disease, which is characterized by rapid onset (\4 weeks' duration) and an aggressive clinical course, particularly if untreated [1][2][3][4][5][6][7][36][37][38]. Acute invasive FRS is seen in immunocompromised patients, particularly those with hematologic malignancies with low absolute neutrophil counts.…”

Differential Diagnosis of Necrotizing Sinonasal Lesions

“…4 Acute invasive fungal rhinosinusitis (FRS) is most commonly seen in immunosuppressed patients, particularly those with hematologic malignancies and a low absolute neutrophil count. [4][5][6][7][8][9][10][11][12] The fungal organisms invade tissue and blood vessels, resulting in tissue necrosis and infarction. Organisms can invade vital structures including the brain and large arteries.…”

“…The diagnosis of acute invasive FRS involves histopathologic identification of invasive fungi in tissue, which is often performed during intraoperative consultation (frozen section). [10][11][12] Histologically, the mucosa shows infarction, vascular thrombosis, and little inflammation ( Figure 1, A through C). Close review shows angioinvasion of fungal forms resulting in lumenal thrombosis.…”

Rhinofacial Aspergillosis in an Infant

“…The incidence of this disease has increased due to uncontrolled diabetes mellitus, hemochromatosis, AIDS, organ transplantation, and hematological malignancies. High mortality rates have been reported, especially in children (1). Besides soil and fruits, Aspergillus and other fungal species can be found in the throat, nasal cavity, and feces of immunocompetent individuals.…”