Fungal diseases of the ear, nose, and throat

Invasive Infections ◽

Chronic Invasive ◽

Nose And Throat

Fungal infection of the ear (otomycosis), nose (fungal rhinosinusitis), and throat (oropharyngeal candidiasis) are common diseases. Fungal laryngeal diseases and invasive otomycosis & acute fungal rhinosinusitis are much less common and occur in immunosuppressed hosts, including those with diabetes. Aspergillus and Candida spp. are the commonest causes of otomycosis, whilst Aspergillus spp. predominate in sinus disease, with members of the Mucorales also causing serious invasive infections. Management of the non-invasive conditions can be difficult, and otomycosis and rhinosinusitis often become chronic. Invasive disease usually requires surgical intervention along with appropriate antifungal therapy. Acute invasive fungal rhinosinusitis has a mortality of approximately 50%.

Fungal Rhinosinusitis: A Retrospective Microbiologic and Pathologic Review of 400 Patients at a Single University Medical Center

International Journal of Otolaryngology ◽

10.1155/2012/684835 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 52

Author(s):

Kathleen T. Montone ◽

Virginia A. Livolsi ◽

Michael D. Feldman ◽

James Palmer ◽

Alexander G. Chiu ◽

...

Keyword(s):

Medical Center ◽

Fungus Ball ◽

Fungal Culture ◽

Non Invasive ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis ◽

Aspergillus Sp ◽

Chronic Invasive

Fungal Rhinosinusitis (FRS) is a well known entity, but only in more recent times have the types of FRS been more fully defined. In this study, we evaluate the diagnosis of FRS in a single medical center. Cases were divided into 2 main categories, non-invasive and invasive. Non-invasive FRS included fungus ball (FB) and allergic fungal rhinosinusitis (AFRS). Invasive FRS included acute invasive fungal rhinosinusitis (AIFRS), chronic invasive fungal rhinosinusitis (CIFRS), and chronic invasive granulomatous fungal rhinosinusitis (CGFRS). Fungal culture data, if available was reviewed. 400 patients with FRS were identified. 87.25% were non-invasive (45% AFRS, 40% FB, and 2% combined AFRS and FB and 12.5% were invasive 11% AIFRS 1.2% CIFRS 0.5% CGFRS. One patient (0.25%) had combined FB/CGFRS.Aspergillus sp.or dematiaceous species were the most common fungi isolated in AFS whileAspergillus sp.was most common in FB and AIFRS. In our experience, most FRS is non-invasive. In our patient population, invasive FRS is rare with AIFRS representing >90% of cases. Culture data supports that a variety of fungal agents are responsible for FRS, butAspergillus sp.appears to be one of the most common organisms in patients with FRS.

Fungal Rhinosinusitis: A Radiological Review with Intraoperative Correlation

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2016.12.009 ◽

2017 ◽

Vol 68 (2) ◽

pp. 178-186 ◽

Cited By ~ 15

Author(s):

Elaine Ni Mhurchu ◽

Javier Ospina ◽

Arif S. Janjua ◽

Jason R. Shewchuk ◽

Alexandra T. Vertinsky

Keyword(s):

Invasive Disease ◽

Clinical Severity ◽

Fungal Colonization ◽

Tissue Destruction ◽

Tissue Invasion ◽

Fungal Rhinosinusitis ◽

Clinical Presentations ◽

Chronic Invasive ◽

Histopathological Evidence

The interaction between fungi and the sinonasal tract results in a range of clinical presentations with a broad spectrum of clinical severity. The most commonly accepted classification system divides fungal rhinosinusitis into invasive and noninvasive subtypes based on histopathological evidence of tissue invasion by fungi. Invasive fungal rhinosinusitis is subdivided into acute invasive and chronic invasive categories. The chronic invasive category includes a subcategory of chronic granulomatous disease. Noninvasive fungal disease includes localized fungal colonization, fungal ball, and allergic fungal rhinosinusitis. Noninvasive disease is simply fungal material (or the products of the inflammatory reaction of the sinus mucosa) that fills the sinuses but does not invade tissue. Bone loss is related to expansion of the sinus(es). Invasive disease causes tissue destruction, such that it expands past the bony confines of the sinuses. It can rapidly spread, causing acute necrosis. Alternatively, there may be slow tissue invasion characterized by symptoms confused with normal sinusitis, but destruction of normal nasal and paranasal structures.

Invasive fungal rhinosinusitis

Romanian Journal of Rhinology ◽

10.2478/rjr-2019-0001 ◽

2019 ◽

Vol 9 (33) ◽

pp. 13-19

Author(s):

Lucia Gariuc ◽

Alexandru Sandul ◽

Lupoi Daniel

Keyword(s):

Risk Factors ◽

Early Treatment ◽

Imaging Techniques ◽

Diagnostic Information ◽

Immunocompromised Patients ◽

Fungal Rhinosinusitis ◽

Chronic Invasive ◽

Systemic Antifungal Therapy

Abstract Invasive fungal rhinosinusitides are a group of disorders with three subtypes (acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive fungal rhinosinusitis), requiring urgent diagnosis and early treatment due to the reserved vital and functional prognosis. This disorder occurs in immunocompromised patients, but it can also occur in immunocompetent people. Aspergillus and Mucormicosis species are the most common microorganisms found in invasive fungal rhinosinusites. The otorhinolaryngologic clinical examination and imaging techniques provide important diagnostic information in patients with risk factors for invasive fungal rhinosinusitis, including intracranial or orbital extension identification. The treatment of invasive fungal rhinosinusites (acute or chronic) consists of reversing immunosuppression, appropriate systemic antifungal therapy and aggressive and prompt surgical debridement of the affected tissues.

NON-INVASIVE FUNGAL RHINOSINUSITIS. ALLERGIC FUNGAL RHINOSINUSITIS

10.33848/foliorl23103825-2019-25-2-59-66 ◽

2019 ◽

Vol 25 (2) ◽

pp. 59-66

Author(s):

L. Gariuc ◽

Keyword(s):

Non Invasive ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis

The impact of COVID-19 outbreak on the incidence of acute invasive fungal rhinosinusitis

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.103080 ◽

2021 ◽

pp. 103080

Author(s):

Wael F. Ismaiel ◽

Mohamed H. Abdelazim ◽

Ibrahim Eldsoky ◽

Ahmed A. Ibrahim ◽

Mahmoud E. Alsobky ◽

...

Keyword(s):

Fungal Rhinosinusitis ◽

The Impact ◽

Invasive Fungal Rhinosinusitis

Chronic Invasive Fungal Rhinosinusitis: A Systematic Review and Meta-analysis

10.1055/s-0041-1725473 ◽

2021 ◽

Author(s):

Nrusheel Kattar ◽

Basit Jawad ◽

Muhib Haidari ◽

Ryan Winters

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Fungal Rhinosinusitis ◽

Chronic Invasive

Allergen Immunotherapy in an HIV+ Patient with Allergic Fungal Rhinosinusitis

Case Reports in Immunology ◽

10.1155/2015/875260 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Ian A. Myles ◽

Satyen Gada

Keyword(s):

Allergen Immunotherapy ◽

Severe Infection ◽

Invasive Fungal Disease ◽

Fungal Disease ◽

Fungal Sinusitis ◽

Opportunistic Pathogens ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis ◽

Chronic Invasive

Patients with HIV/AIDS can present with multiple types of fungal rhinosinusitis, fungal balls, granulomatous invasive fungal rhinosinusitis, acute or chronic invasive fungal rhinosinusitis, or allergic fungal rhinosinusitis (AFRS). Given the variable spectrum of immune status and susceptibility to severe infection from opportunistic pathogens it is extremely important that clinicians distinguish aggressive fungal invasive fungal disease from the much milder forms such as AFRS. Here we describe a patient with HIV and AFRS to both remind providers of the importance of ruling out invasive fungal disease and outline the other unique features of fungal sinusitis treatment in the HIV-positive population. Additionally we discuss the evidence for and against use of allergen immunotherapy (AIT) for fungal disease in general, as well as the evidence for AIT in the HIV population.