Prognosis of acute invasive fungal rhinosinusitis related to underlying disease

Valera, Fabiana Cardoso Pereira; Lago, Tassiana do; Tamashiro, Edwin; Yassuda, Camila Carrara; Silveira, Flávia; Anselmo‐Lima, Wilma Terezinha

doi:10.1016/j.ijid.2011.08.005

Cited by 70 publications

(93 citation statements)

References 13 publications

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“…The pain antecedes ophthalmic signs and is consistent with a lesion arising in the sphenoid sinus, which commonly is the site of origin. This presentation suggests a long differential diagnosis, including other infectious, inflammatory, neoplastic, vascular, and neuro-ophthalmic disorders [5][6][7][8][9]. Some of these lead to corticosteroid administration, which worsens aspergillosis infection.…”

Section: Discussionmentioning

confidence: 99%

Invasive Aspergillosis in an Immunocompetent Asian Teenager

Paulino¹,

Agahan²,

Trio-Ranche³

2016

J Clin Exp Ophthalmol

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Purpose: To report a case of invasive Sino-orbital aspergillosis in an Immunocompetent Asian teenager Method: Case ReportResult: An immunocompetent Asian teenager with no comorbidities presented with a unilateral orbital proptosis with orbital cellulitis-like symptoms was unresponsive to medical therapy. Findings on computed tomography demonstrated a fairly homogenous mass occupying the entire left maxillary sinus, with erosion of the orbital floor and medial wall to invade the ethmoids and the orbit. Excision biopsy of the mass showed fungal elements with tissue invasion and granulomatous reactions. Treatment included excision of the mass and systemic antifungals. During the course of treatment, however, the patient lost vision on the affected eye, which did not improve even after excision of mass and treatment of the infection Conclusion: Clinicians should be aware of the possibility of having a fungal infection mimicking other infections and tumors in immunocompetent host since prompt treatment could possibly save the vision, and, in the long run, the patient's life.

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Section: Discussionmentioning

confidence: 99%

Invasive Aspergillosis in an Immunocompetent Asian Teenager

Paulino¹,

Agahan²,

Trio-Ranche³

2016

J Clin Exp Ophthalmol

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“…11 In the literature, the survival rates vary depending on the underlying etiology, ante-mortem diagnosis, and treatment. 1,3,6 In both of our cases, the treatments required for haematological diseases, which were considered predisposing conditions, were applied. Surgical debridement could not be performed due to impairment in the patients' general conditions, and the patients died despite the systemic amphotericin B treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Long term antibiotherapy, steroid use, chronic bacterial sinusitis, presence of diseases such as uncontrolled diabetes mellitus, haematological malignancies with suppression or collapse of the immune system, patients receiving chemotherapy subsequent to bone marrow transplantation or aplastic anemia also constitute an important place in the risk group. [1][2][3][4][5][6][7] The most frequently determined agents are Aspergillus spp. and the fungi in Mucorales species.…”

Section: Introductionmentioning

confidence: 99%

Acute invasive rhinosinusitis case caused by Aspergillus flavus in two patients prediagnosed with mucormycosis

Aslan¹,

Oz²,

Bör³

et al. 2015

Journal of Microbiology and Infectious Diseases

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Acute invasive rhinosinusitis caused by Aspergillus spp. may lead to invasive disease and mortality, especially in immunocompromised individuals. In this report, two invasive fungal rhinosinusitis cases in an immune compromised patient have been presented that were pre-diagnosed with mucormycosis, but with a positive culture for Aspergillus flavus. Twenty-four years old male patient with aplastic anemia and seven years old patient with acute lymphoblastic leukemia; facial pain, edema, and necrotic lesions developed in both cases. Tissue samples were obtained from lesions through the nose by biopsy for definitive diagnosis. Septate fungal hyphae observed on the microscopic examination of the specimen, and A. flavus was isolated in the culture in both cases. Surgical debridement could not be performed because of patients' general conditions. Despite antifungal therapy and treatments, patients died. Delay in diagnosis and treatment may lead to high mortality rates. These cases emphasize the importance of diagnosis with culture. J Microbiol Infect Dis 2015;5(3): 137-141Key words: Acute invasive fungal rhinosinusitis, Aspergillus flavus, diagnosis. Mukormikoz öntanılı iki olguda Aspergillus flavus'un neden olduğu akut invaziv rinosinüzit enfeksiyonu ÖZETAspergillus türlerinin neden olduğu akut invaziv fungal rinosinüzit; immünsüprese hastalarda mortaliteye yol açabilir.Rinoserebral mukormikoza klinik olarak benzediğinden mukormikoz ön tanısı almış ancak kültürde etken olarak Aspergillus flavus üretilmiş iki invaziv fungal rinosinüzit olgusu bu raporda sunulmuştur. Aplastik anemi tanısıyla takip edilen 24 yaşındaki erkek hasta ve akut lenfoblastik lösemi tanısıyla izlenen yedi yaşındaki kız çocuğunda yüzde ağrı, ödem, ve burun çevresinde nekrotik lezyonlar mevcuttu. Antifungal tedaviye rağmen burunda nekroz gelişti. Tanı amacıyla burundaki lezyondan alınan biyopsi örneğinin mikroskobik incelemesinde septalı hifler görüldü ve kültürde iki olguda da A. flavus izole edildi. İki olgumuzda da gerekli tedaviler yapılmış olup cerrahi debridman hastaların genel durum bozukluğu nedeniyle yapılamadı ve antifungal tedaviye rağmen hastalar kaybedildi. İnvaziv fungal enfeksiyonlarda erken tanı ve tedavi hayati önem taşımaktadır. Bu olgular, fungal enfeksiyonların tanısında ve tedaviyi doğru şekilde yönlendirebilmede kültürün önemini vurgulaması açısından önemlidir.Anahtar kelimeler: Akut invaziv fungal rinosinüzit, Aspergillus flavus, tanı

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“…The extent of the disease was inversely related to the prognosis. 2 Lin et al 3 demonstrated a mortality rate of 26.7% when invasive aspergillosis was restricted to the nasal cavity and sinuses compared with 88% when the infection was highly disseminated. Meanwhile, Valera et al 2 reported a mortality rate of 33% when only the lateral wall was involved, increased to 67% when the disease reached the septum, and 100% when it is beyond the nasal cavity.…”

Section: Discussionmentioning

confidence: 99%

Nasal Eschar

Idris

Lim²

2012

Journal of Pediatric Hematology/Oncology

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Most invasive fungal sinusitis occurs in immunocompromised adult patients. We present the case study of a 12-year-old boy diagnosed with acute myeloblastic leukemia undergoing chemotherapy. He developed a progressive darkening discoloration over the dorsum of the nose that turned into an eschar. Nasal endoscopy revealed extensive necrotic tissue in the nasal cavity mucosa, inferior and middle turbinates, and septal cartilage that extended to the eschar of the skin over the nasal dorsum. Histopathology showed aspergillus invasive fungal rhinosinusitis.

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Prognosis of acute invasive fungal rhinosinusitis related to underlying disease

Abstract: Early medical and surgical treatment is essential to improve the prognosis of AIFRS patients. A poorer prognosis was associated with underlying disease and extensiveness of AIFRS, but not to the fungus isolated.

Cited by 70 publications

References 13 publications

Invasive Aspergillosis in an Immunocompetent Asian Teenager

Invasive Aspergillosis in an Immunocompetent Asian Teenager

Acute invasive rhinosinusitis case caused by Aspergillus flavus in two patients prediagnosed with mucormycosis

Nasal Eschar

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