Invasive fungal rhinosinusitis in adult patients: Our experience in diagnosis and management

Pagella, Fabio; Bernardi, Francesca De; Gasperina, Daniela Dalla; Pusateri, Alessandro; Matti, Elina; Avato, Irene; Cavanna, C.; Zappasodi, Patrizia; Bignami, Maurizio; Bernardini, Elena; Grossi, Paolo; Castelnuovo, Paolo

doi:10.1016/j.jcms.2015.12.016

Cited by 26 publications

(41 citation statements)

References 46 publications

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“…Two studies report their experience with a larger population of CIFS patients. Pagella et al . describe a retrospective case series with acute and chronic invasive fungal infections.…”

Section: Discussionmentioning

confidence: 99%

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

D’Anza

Stokken

Greene

et al. 2016

Int Forum Allergy Rhinol

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“…Two studies report their experience with a larger population of CIFS patients. Pagella et al . describe a retrospective case series with acute and chronic invasive fungal infections.…”

Section: Discussionmentioning

confidence: 99%

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

D’Anza

Stokken

Greene

et al. 2016

Int Forum Allergy Rhinol

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“…Here, 24 cases of IFS were reported; these patients were identified in hospitalized patients from October 2012 to October 2013. It seems that there were more patients in the current study compared with some other studies; Foshee et al, identified twentyseven patients in departmental records from 1998 to 2014 in a single center in Philadelphia (19), and Pagella et al, reported 18 cases of IFS among patients with hematological malignancy and diabetes from 2002 to 2013 in a hospital in Italy (20). IFS is developed more frequently in patients with acute myeloid leukemia (AML) non-M3 (45.8%).…”

Section: Discussionmentioning

confidence: 50%

Clinical Manifestation and Diagnosis of Invasive Fungal Sinusitis in Patients with Hematological Malignancy

Mardani

Faghani

Tabarraee

et al. 2016

Arch Clin Infect Dis

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Background: Invasive fungal sinusitis (IFS) is a potentially deadly infection especially in patients with immunocompromising conditions. Objectives: The current study aimed to evaluate the clinical manifestations, outcomes and factors that may affect survival of patients with IFS. Methods: A cross sectional descriptive study was performed on hospitalized patients admitted to Taleghani hospital affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, from October 2012 to October 2013. The clinical data of 24 patients with IFS were reviewed. All patients had hematologic malignancies, and received broad spectrum chemotherapy. Demographic data, clinical characteristics, presented symptoms and signs, underlying diseases and outcomes of the patients were studied. Results: The age range of patients was 15 -60 years. The IFS was proven, probable and possible in 25%, 66.7% and 8.3% of the cases, respectively. Serum galactomannan antigen was positive in 41.6% of the cases; 15 out of 24 cases with IFS had received antifungal chemoprophylaxis before diagnosis, 54% fluconazole and 8.3% itraconazole. Aspergillus flavus (33%), Aspergillus fumigatus (20.8%), Aspergillus niger (16.7%) and Mucor spp. (16.7%) were responsible for incidence of IFS; 54% of IFS cases occurred in summer and 91.6% of occurred during hospital construction; a risk factor in 91.6% of the cases. Conclusions: Current study revealed that A. flavus was the most common isolated pathogen. Moreover, A. fumigatus was the second common isolated pathogen in patients with IFS. Additionally, the hospital construction was an important environmental risk factor for acquisition of infection in patients with hematological malignancy. The most common season for IFS incidence was summer. Additionally, the common causes of death in patients with IFS were primary disease and also resistance to chemotherapy (37.5%).

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“…The associated co-morbidities with AIFRS as seen in our cases were similar to a study in Thailand (2008) which found diabetes to be associated in 66.6% of their AIFRS cases. However, Pagella et al [18] reported in AIFRS cases haemtological malignancies represented the principal comorbidity (100%) and Montone et al [14] from USA also found haematological disorders (84%) to be more commonly associated with AIFRS patients [5,8]. Also Micheal et al [17] had an association of diabetes in 62.7% of AIFRS cases in their study.…”

Section: Discussionmentioning

confidence: 85%

“…In CIFRS cases, diabetes was present in 22.2% and hypertension in 11.1% cases [17]. While Pagella et al [18] reported in chronic form diabetes mellitus (87.5%) to be the principal comorbidity. Micheal et al [17] in Tamilnadu found underlying co-morbidities in 53% of CIFRS cases when compared to 90.3% in AIFRS forms which included 62.7% cases of diabetes.…”

Section: Discussionmentioning

confidence: 92%

Invasive Fungal Rhinosinusitis: An Observational Study in an Indian Tertiary Care Hospital

Kaur¹,

Lavanya²

2016

Lung Dis Treat

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Invasive fungal rhinosinusitis (IFRS) is a challenging condition and the mortality of IFRS in immuno compromised patients is very high. 75 patients of suspected FRS were included to study the burden and the clinicopathological and mycological profile of invasive fungal rhinosinusitis (FRS) in these patients. The samples collected were exudate from nasal debri, discharge and intraoperative tissue sample and were subjected to direct microscopy to histopathological examination and direct microscopy (KOH and calcofluor white) and culture on Sabouraud dextrose agar. Identification of molds and yeasts were done by conventional methods. 25 cases were suspected to have IFRS were confirmed by microbiological and histo pathological examination, comprising 56% of AIFRS (acute IFRS), 36% CIFRS (chronic IFRS) and 8% CGFRS (chronic granulomatous FRS). Rhizopus arrhizus (64.2%) was the most common isolate followed by Aspergillus flavus (35.7%). Mucor species were solely isolated from AIFRS (14.3%). In CIFRS, Aspergillus flavus (44.4%) seemed to be the major isolate with Aspergillus niger, Alternaria spp., Penicillium spp. and Candida albicans. Necrosis of submucosa, bone, vascular tissue was seen in 96% of cases with aseptate hyphae in 78.5% AIFRS and 77.7% in CIFRS. Radiological features help in presumptive diagnosis of FRS. Direct microscopy along with culture conformation is important for diagnosis and early initiation of treatment.

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Invasive fungal rhinosinusitis in adult patients: Our experience in diagnosis and management

Cited by 26 publications

References 46 publications

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

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

Clinical Manifestation and Diagnosis of Invasive Fungal Sinusitis in Patients with Hematological Malignancy

Invasive Fungal Rhinosinusitis: An Observational Study in an Indian Tertiary Care Hospital

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