Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

D’Anza, Brian; Stokken, Janalee K.; Greene, J. Scott; Kennedy, Thomas L.; Woodard, Troy D.; Sindwani, Raj

doi:10.1002/alr.21828

Cited by 28 publications

(48 citation statements)

References 28 publications

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“…Its mortality is high even with timely diagnosis and treatment: ∽50% in the largest meta‐analysis to date . Risk factors for AIFS are related to functional and quantitative neutropenia, such as in cases of uncontrolled diabetes mellitus, hematologic malignancy (especially acute myeloid leukemia), chemotherapy, corticosteroid use, renal/liver failure, bone marrow transplantation (BMT), HIV/AIDS, or autoimmune disease …”

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confidence: 99%

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

Wandell

Miller

Rathor

et al. 2018

Int Forum Allergy Rhinol

101

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confidence: 99%

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

Wandell

Miller

Rathor

et al. 2018

Int Forum Allergy Rhinol

101

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“…Panda et al reported no recurrence after 1 year of follow-up in 6 chronic invasive cases [14]. D’Anza et al also found no recurrence in a study of 6 patients with CIFRS [15]. The literature investigating the treatment of CIFRS is comprised almost exclusively of retrospective case series, and there is no consensus on the best treatment [16].…”

Section: Discussionmentioning

confidence: 99%

Entities of Chronic and Granulomatous Invasive Fungal Rhinosinusitis: Separate or Not?

Zhou

Wang

et al. 2018

Open Forum Infectious Diseases

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BackgroundChronic and granulomatous invasive fungal rhinosinusitis are important causes of blindness and craniocerebral complications. However, the classification of these 2 diseases remains controversial.MethodsWe retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons.ResultsAmong 55 patients enrolled in our study, 11 (11/55, 20%) had granulomatous invasive fungal rhinosinusitis (GIFRS) and 44 (44/55, 80%) had chronic invasive fungal rhinosinusitis (CIFRS). Aspergillus fumigatus and Dematiaceous hyphomycetes were identified in 2 patients with GIFRS. Compared with granulomatous type, CIFRS was more frequently encountered in immunocompromised patients (P = .022), and the time from onset to diagnosis was much shorter (P = .001). Proptosis and orbital apex syndrome showed no significant difference between granulomatous and CIFRS in our study. The treatment options and prognosis of both diseases also showed no significant difference.ConclusionsDespite the consensus on histopathology, the classification of the chronic and granulomatous types may need further evaluation in clinical considerations.

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“…Chronic invasive fungal sinusitis (CIFS) is a rare infection that typically occurs in immunocompromised patients, but has a more indolent clinical course than its counterpart acute invasive fungal sinusitis (AIFS) 1‐4 . Similar to AIFS, in CIFS, fungi invade the mucosa of the nasal cavity or paranasal sinuses and can result in necrosis through angioinvasion.…”

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confidence: 99%

“…Importantly, CIFS also differs from chronic granulomatous invasive fungal sinusitis (CGIFS) in that there are no granulomas seen on histopathology. Further, most cases of CGIFS have been described in immunocompetent patients from the Sudan, Pakistan, and India, whereas this geographic bias has not been seen in CIFS 2,5 . However, as compared to AIFS in particular, the clinical outcomes of CIFS have been less well described.…”

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confidence: 99%

A multi‐institutional review of outcomes in biopsy‐proven chronic invasive fungal sinusitis

Humphreys

Wandell

Miller

et al. 2020

Int Forum Allergy Rhinol

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Background: Chronic invasive fungal sinusitis (CIFS) is a rare, life-threatening infection of the nose and sinuses. This study aims to identify factors that impact survival in 1 of the largest cohorts to date.Methods: Pathology records were reviewed for biopsyproven CIFS from 3 tertiary academic institutions from 1995 to 2016. Variables were analyzed using log-rank survival analysis. Univariate Cox regression was performed at 1 and 12 months.Results: Thirty-eight patients were included. Hematologic malignancy and diabetes were the most common underlying diseases (32% each). Aspergillus was the most common fungus (63%). Greater than 75% of the patients had an absolute neutrophil count (ANC) >1000 at the time of diagnosis. Overall survival at 1, 6, and 12 months was 89%, 68%, and 48%, respectively. In univariate analysis, factors associated with worse survival included: ANC <500 at 12 months (hazard ratio [HR] 4.8; p = 0.01), ANC <1000 at 12 months (HR 5.8; p = 0.001), and recent chemotherapy (HR 4; p = 0.01). The following factor was associated with improved survival in univariate analysis: ANC as a linear variable in the entire cohort (HR 0.7; p = 0.005). Conclusion:We present a multi-institutional case-series of CIFS and long-term follow-up. ANC <1000 at time of diagnosis and recent chemotherapy (within 1 month of diagnosis) are associated with poorer survival, whereas a rising ANC >1000 is associated with improved survival at 12 months. Further prospective studies are needed to further define factors that affect outcomes. C 2020 ARS-AAOA, LLC.

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Chronic invasive fungal sinusitis: characterization and shift in management of a rare disease

Cited by 28 publications

References 28 publications

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

Entities of Chronic and Granulomatous Invasive Fungal Rhinosinusitis: Separate or Not?

A multi‐institutional review of outcomes in biopsy‐proven chronic invasive fungal sinusitis

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