scholarly journals Emergence of Invasive Fungal Rhinosinusitis in Recently Recovered COVID-19 Patients

2021 ◽  
pp. 000348942110609
Author(s):  
Vivek Dokania ◽  
Ninad Subhash Gaikwad ◽  
Vinod Gite ◽  
Shashikant Mhashal ◽  
Neeraj Shetty ◽  
...  
Keyword(s):  
Asymptomatic Carrier ◽  
Infratemporal Fossa ◽  
Prospective Longitudinal Study ◽  
Early Management ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Facial Swelling ◽  
Underlying Disorder ◽  
Prospective Longitudinal ◽  
Invasive Fungal Rhinosinusitis

Objective: The risk of invasive fungal rhinosinusitis is increased in Coronavirus disease 2019 (COVID-19) because of its direct impact in altering innate immunity and is further exacerbated by widespread use of steroids/antibiotics/monoclonal antibodies. The study aims to describe this recently increased clinical entity in association with COVID-19. Method: A prospective, longitudinal study including patients diagnosed with acute invasive fungal rhinosinusitis (AIFRS) who recently recovered from COVID-19 infection or after an asymptomatic carrier state. A single-center, descriptive study investigating demographic details, clinical presentation, radio-pathological aspects, and advocated management. Result: A total of 21 patients were included with a mean age of 49.62 years (SD: 14.24). Diabetes mellitus (DM) was the most common underlying disorder (90.48%), and 63.16% of all patients with DM had a recent onset DM, either diagnosed during or after COVID-19 infection. Nineteen patients (90.48%) had recently recovered from active COVID-19 infection, and all had a history of prior steroid treatment (oral/parenteral). Remaining 2 patients were asymptomatic COVID-19 carriers. Surprisingly, 2 patients had no underlying disorder, and 5 (23.81%) recently received the Covishield vaccine. Fungal analysis exhibited Mucor (95.24%) and Aspergillus species (14.29%). Most common sign/symptom was headache and facial/periorbital pain (85.71%), followed by facial/periorbital swelling (61.90%). Disease involvement: sinonasal (100%), orbital (47.62%), pterygopalatine fossa (28.58%), infratemporal fossa (14.29%), intracranial (23.81%), and skin (9.52%). Exclusive endoscopic debridement and combined approach were utilized in 61.90% and 38.10%, respectively. Both liposomal amphotericin B and posaconazole were given in all patients except one. Conclusion: A high suspicion of AIFRS should be kept in patients with recent COVID-19 infection who received steroids and presenting with headache, facial pain, and/or facial swelling. Asymptomatic COVID-19 carriers and COVID-19 vaccinated candidates are also observed to develop AIFRS, although the exact immuno-pathogenesis is still unknown. Prompt diagnosis and early management are vital for a favorable outcome.

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

2021 ◽  
pp. 103080
Author(s):  
Wael F. Ismaiel ◽  
Mohamed H. Abdelazim ◽  
Ibrahim Eldsoky ◽  
Ahmed A. Ibrahim ◽  
Mahmoud E. Alsobky ◽  
...  
Keyword(s):  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
The Impact ◽  
Invasive Fungal Rhinosinusitis

Acute invasive fungal rhinosinusitis: MR imaging features and their impact on prognosis

2018 ◽  
Vol 60 (7) ◽  
pp. 715-723 ◽  
Author(s):  
Ye Ra Choi ◽  
Ji-hoon Kim ◽  
Hye Sook Min ◽  
Jae-Kyung Won ◽  
Hyun Jik Kim ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Imaging Features ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

Fungal diseases of the ear, nose, and throat

2017 ◽  
Author(s):  
Arunaloke Chakrabarti
Keyword(s):  
Invasive Disease ◽  
Sinus Disease ◽  
Laryngeal Diseases ◽  
Non Invasive ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Infections ◽  
Invasive Fungal Rhinosinusitis ◽  
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%.

Retrospective Analysis of Patients With Acute Invasive Fungal Rhinosinusitis in a Single Tertiary Academic Medical Center: A 10-Year Experience

2019 ◽  
Vol 34 (3) ◽  
pp. 324-330
Author(s):  
Gennadiy Vengerovich ◽  
Kristen A. Echanique ◽  
Ki Wan Park ◽  
Christine Wells ◽  
Jeffrey D. Suh ◽  
...  
Keyword(s):  
Medical Management ◽  
Medical Center ◽  
Academic Medical Center ◽  
Sinus Surgery ◽  
Open Approach ◽  
Presenting Symptoms ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Academic Medical ◽  
Invasive Fungal Rhinosinusitis

Background Acute invasive fungal rhinosinusitis (AIFRS) is an aggressive, potentially fatal disease that can spread rapidly to the orbit and intracranial structures causing significant mortality and morbidity. Objective In this study, we present a 10-year experience from a tertiary academic medical center of patients presenting with AIFRS. Data on presentation, mortality rate, comorbidities, surgical, and medical management were analyzed. Methods A retrospective chart review was performed in a tertiary academic medical center of patients with AIFRS from January 2009 through February 2019. Data collected included demographics, presenting symptoms, comorbidities, immunosuppression status, endoscopic and imaging findings, orbital and intracranial complications, surgical and medical management, as well as outcomes and mortality. Results A total of 34 patients were identified. In our series, mortality was noted to be 61.8%, excluding patients who were lost to follow-up. The most common presenting symptoms included facial pain, ophthalmologic complaints, headaches, and proptosis. Only 4 of the 34 patients did not undergo surgical intervention, as they were not deemed surgical candidates; they all succumbed to their disease. Twenty-six of the 30 surgical patients (86.7%) underwent endoscopic sinus surgery, 8 underwent an open approach (26.7%), while 7 patients underwent orbital exenteration (23.3%). All patients had surgical pathology consistent with AIFRS. Fungal species isolated from culture included Aspergillus, Mucor/ Rhizopus, Candida, Cunninghamella Scedosporium boydii, Paecilomyces, and Scopulariopsis. Medical therapies included intravenous amphotericin B, caspofungin, posaconazole, voriconazole, isavuconazole, and micafungin. Conclusion AIFRS was associated with 61.8% mortality in our series of 34 patients over the past 10 years. Early diagnosis, as well as rapid and aggressive surgical and medical management, is necessary for optimal outcomes in this devastating disease.

Acute Invasive Fungal Rhinosinusitis

2016 ◽  
Vol 154 (4) ◽  
pp. 759-764 ◽  
Author(s):  
Sakeena J. Payne ◽  
Ron Mitzner ◽  
Sudhir Kunchala ◽  
Lauren Roland ◽  
Johnathan D. McGinn
Keyword(s):  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

Acute invasive fungal rhinosinusitis: our experience with 19 patients

2008 ◽  
Vol 266 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Ahmet Emre Süslü ◽  
Oğuz Öğretmenoğlu ◽  
Nilda Süslü ◽  
Ömer Taşkın Yücel ◽  
Tevfik Metin Önerci
Keyword(s):  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

scholarly journals In Situ Hybridization for Specific Fungal Organisms in Acute Invasive Fungal Rhinosinusitis

2011 ◽  
Vol 135 (2) ◽  
pp. 190-199 ◽  
Author(s):  
Kathleen T. Montone ◽  
Virginia A. LiVolsi ◽  
Donald C. Lanza ◽  
David W. Kennedy ◽  
James Palmer ◽  
...  
Keyword(s):  
In Situ Hybridization ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Fungal Organisms ◽  
Invasive Fungal Rhinosinusitis

scholarly journals Acute Invasive Fungal Rhinosinusitis-Related Orbital Infection: A Single Medical Center Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yu-Fang Huang ◽  
Kai-Li Liang ◽  
Chiao-Ying Liang ◽  
Po-Chin Yang ◽  
Jun-Peng Chen ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Hematological Malignancy ◽  
Medical Center ◽  
Initial Presentation ◽  
Rapid Progression ◽  
Orbital Involvement ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Orbital Complication ◽  
Invasive Fungal Rhinosinusitis

Backgrounds. Acute invasive fungal rhinosinusitis (AIFRS) is a hazardous infectious disease with rapid progression and high mortality and morbidities. Further orbital involvement is commonly seen. This study aims to analyze risk factors, clinical characteristics, and outcomes between patients with or without orbital involvement. Methods. A retrospective review was performed in a single tertiary medical center over a span of 13 years (2005–2018). A total of 21 patients with diagnosis of AIFRS were enrolled. We reviewed the patients’ basic characteristics, comorbidities, clinical presentations, image study findings, culture pathogens, and treatment outcomes and analyzed the differences between orbital-involved and orbital sparing disease. Results. The most common comorbidities in AIFRS were diabetes mellitus (DM) and hematological malignancy. Nine the 21 AIFRS patients had orbital-involved disease. Patients with orbital involvement had a higher prevalence of DM ( p < 0.05 ). Image studies revealed significant infection of the ethmoid sinus, sphenoid sinus, and frontal sinus in the group with orbital complication ( p < 0.05 ). Mucor, Rhizopus, and Aspergillus were cultured in both groups. Five patients in the orbital involvement group expired, with all of them having an initial presentation of conscious disturbance ( p < 0.01 ). Rhino-orbital-cerebral fungal infection was noticed in 3 of the 5 expired patients. Conclusion. In AIFRS patients, DM other than hematological malignancy was the main risk factor for orbital-involved disease. Patients with ethmoid, sphenoid, or frontal sinusitis had a higher possibility of orbital complication. Poor consciousness at initial presentation revealed highest possibility of rhino-orbital-cerebral fungal infection and led to death.

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