Invasive Fungal Sinusitis: A 15-Year Review from a Single Institution

Abstract

We have found the overall mortality rate directly related to IFS to be 18%. The rate is higher for diabetic patients than for patients with hematologic causes for their immunosuppression. This is likely because of the higher index of suspicion and early diagnosis and treatment of patients with neutropenia and a less-fulminant, slower-progressing form of IFS from Aspergillus, apparently a less virulent fungus than Mucor. Intracranial involvement and failure to recover from neutropenia are the factors that led to poor prognosis in this series.

Acute Invasive Fungal Rhinosinusitis: A Comprehensive Update of CT Findings and Design of an Effective Diagnostic Imaging Model

“…When considered as binary variables (ie, absence [0]/presence [1][2][3][4][5]), these 4 variables displayed relatively high specificities (93%-100%) and sensitivities (50%-74%, Fig 1). A correlation of note is that sphenopalatine foramen involvement was present in 72% of patients positive for AIFR with pterygopalatine fossa involvement.…”

Resolution of invasive fungal sinusitis in immunocompromised patients: neutrophil count is crucial beside a combined medical and surgical approach

“…The occurrence of this complication often compromises the therapeutic programme for the underlying haematological condition, necessitating a delay or cessation of chemotherapy with a subsequent high risk of relapse or progression. The acute fulminant form is characterised by its speed of evolution and is associated with a high mortality rate that reaches 100% in cases of intracranial mycotic dissemination [3]. The clinical onset is generally subtle and insidious; facial swelling or pain with or without fever must be promptly considered as possible signs of invasive sinusitis.…”

“…The fungi most frequently involved are Aspergillus and Zygomicetes. Prognosis is related to various factors, such as the speed of diagnosis and treatment, the type of fungal infection [3], dissemination to the central nervous system, and complete neutrophil recovery [4]. The scarce information in the literature on invasive fungal sinusitis in immunocompromised patients highlights the importance and efficacy of a combined surgical and medical approach [5].…”

Rhinocerebral mucormycosis: a case series

“…21 It is evident that prompt diagnosis and early initiation of management in form of surgical debridement with systemic antifungal therapy and correction of underlying predisposing risk factors, if possible; gives most promising results leading to decrease in morbidity and mortality. 22 According to few recent studies if treatment with polyene antifungal is initiated within 5 days of diagnosis of mucormycosis, survival was markedly improved compared to late initiation of treatment. (83% vs. 49% survival).…”