scholarly journals Chronic Invasive Fungal Sinusitis: A Report of Two Atypical Cases

2002 ◽  
Vol 81 (7) ◽  
pp. 462-466 ◽  
Author(s):  
Nicolas Y. Busaba ◽  
Daryl G. Colden ◽  
William C. Faquin ◽  
Salah D. Salman
Keyword(s):  
Soft Tissues ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Intracranial Extension ◽  
Dependent Diabetes Mellitus ◽  
Variant Form ◽  
Fungal Sinusitis ◽  
Pathologic Examination ◽  
Invasive Fungal Sinusitis ◽  
Fungal Hyphae

The purpose of this article is to describe a chronic variant of invasive fungal sinusitis (IFS) and discuss its management. This is a retrospective review of two cases of IFS that were characterized by atypical clinical courses. Patient 1 was a 75-year-old man with noninsulin-dependent diabetes mellitus who came to us with a 5-month history of headache. Computed tomography detected an opacified left sphenoid sinus. After the man failed to respond to medical therapy, he underwent a left endoscopic sphenoidotomy. Pathologic examination revealed that septate, branching fungal hyphae had invaded the soft tissues. The patient was started on oral itraconazole, but later switched to intravenous amphotericin B in response to intracranial extension. The man's disease stabilized, but he died a little more than 1 year later of unrelated causes. Patient 2 was an otherwise healthy 41-year-old woman who came to us with nasal congestion and unilateral nasal polyps. She underwent endoscopic sinus surgery. Pathologic examination identified granulomatous sinusitis and septate, branching fungal hyphae that had invaded the soft tissue of the middle turbinate. The patient was not treated with systemic antifungal medications because of the localized nature of the fungal invasion and the lack of bone invasion or erosion. She has now been symptom-free for 5 years. These two cases demonstrate that IFS can appear in a chronic variant form that is characterized by an indolent course and histologic evidence of tissue invasion by fungal hyphae. The type of treatment is dependent on the extent of the disease on initial examination and the rapidity of its progression.

Scytalidium dimidiatum associated invasive fungal sinusitis in an immunocompetent patient

2014 ◽  
Vol 128 (11) ◽  
pp. 1018-1021 ◽  
Author(s):  
A Hariri ◽  
N Choudhury ◽  
H A Saleh
Keyword(s):  
Corticosteroid Treatment ◽  
Fruit Trees ◽  
Immunocompetent Patient ◽  
Human Infection ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Endemic Region ◽  
Invasive Fungal Sinusitis ◽  
First Case

AbstractBackground:Scytalidium dimidiatum is a soil and plant pathogen that frequently affects fruit trees, but can also cause human infection. There are only two reported cases of invasive fungal sinusitis involving this rare micro-organism.Objective:This paper reports the first case of invasive fungal sinusitis caused by Scytalidium dimidiatum occurring in a young immunocompetent patient from a non-endemic region, and discusses potential sources of exposure and relevance of local factors.Method:Case report.Results:The patient was treated successfully with a combination of functional endoscopic sinus surgery, and antifungal and corticosteroid treatment.Conclusion:This paper describes the first reported case of invasive fungal sinusitis secondary to Scytalidium dimidiatum in a young immunocompetent patient from a non-endemic region. Importance is placed on following a systematic process of investigation and management, and adhering to well-defined basic surgical principles.

scholarly journals Orbital apex syndrome with frontal abscess secondary to sinusitis due to Candida guilliermondii

2021 ◽  
Vol 3 (2) ◽  
pp. 133-138
Author(s):  
Muhd-Syafi Abd Bari ◽  
Mas Edi ◽  
Hudzaifah Nordin ◽  
Rosdan Salim ◽  
Zamzuri Idris ◽  
...  
Keyword(s):  
Immunocompromised Patient ◽  
Opportunistic Pathogen ◽  
Candida Guilliermondii ◽  
Intracranial Extension ◽  
Fungal Sinusitis ◽  
Team Management ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Case Presentation ◽  
Invasive Fungal Sinusitis

Candida guilliermondii is an opportunistic pathogen that rarely causes invasive candidiasis even in immunocompromised humans. We report a case presentation of invasive C. guilliermondii rhinosinusitis causing an orbital and intracranial extension (frontal lobe abscess). An aggressive multidisciplinary team management is a key approach in invasive fungal sinusitis and avoided mortality in this case. When orbital apex syndrome secondary to sinusitis is encountered in an immunocompromised patient, the treating physician should consider fungal infection as a causative agent.

A Case of Relapse of Invasive Fungal Sinusitis after Endoscopic Sinus Surgery

2013 ◽  
Vol 106 (2) ◽  
pp. 115-121
Author(s):  
Kenji Noda ◽  
Satoru Kodama ◽  
Hideaki Mabuchi ◽  
Kanako Noda ◽  
Masashi Suzuki
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis

Efficacy of Different Modalities of Treatment in Management of Different Types of Fungal Sinusits

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
AbdElhamid AbdElhamid Al-Nashar ◽  
Waleed Farag Ezzat ◽  
Mohammed Abdelaleem Mohammed ◽  
Mohammed Al-Shahat Ibrahim Al-Bahet
Keyword(s):  
Antifungal Therapy ◽  
Endoscopic Sinus Surgery ◽  
Endoscopic Technique ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Fungal Ball ◽  
Non Invasive ◽  
Invasive Fungal Sinusitis ◽  
Canine Fossa ◽  
Different Types

Abstract Background Fungal sinusitis is generally classified into invasive and non invasive fungal sinusitis based on histological features, invasive fungal sinusitis divided into acute, chronic and chronic granulomatous invasive fungal sinusitis. While non invasive fungal sinusitis include saprophytic fungal infestation, fungal ball, and fungus-related eosinophilic. Distinguishing invasive disease from noninvasive disease is important because the treatment and prognosis are different for each. AIM A systemic review of effective and safe method in management of different types of fungal sinusitis either by medical or surgical approaches or even combined. Be up to date with the different upcoming new modalities. Methodology A meta-analysis study is done to evaluate the medical and surgical outcomes of patients with invasive and noninvasive Fungal Sinusits. Results Finally, forty-five studies were included in the present systematic review and metaanalysis. Fifteen included studies (No = 539 patients) assessed different modalities for management of fungal ball, via classic endoscopic technique, Canine-fossa approach, gauze technique and osteoplastic approach for FB of the maxillary sinus. The results showed that functional endoscopic sinus surgery has led to success rate of 98.1%. Twenty included studies (No = 806 patients) have assessed the efficacy and safety of different modalities for the management of allergic fungal sinusitis via,Endoscopic Sinus Surgery, Post-ESS Systemic steroids, Antifungals and immunotherapy. The results showed that ESS represents the firstline management strategy of AFRS, followed by aggressive medical therapies, the recurrence rate after postoperative steroids was 20.6%, postoperative antifungals was 40% and after immunotherapy was 9.1%. Ten studies (No = 327 patients) for Invasive Fungal Sinusitis.the results showed that combination of systematic antifungal therapy and aggressive surgical debridement are the treatment of choice. Conclusion FESS is the treatment of choice of fungal ball via classic endoscopic technique, Canine-fossa approach, gauze technique and osteoplastic approach. AFS treatment consists of surgical extirpation of the allergic mucin and polyps with maintenance of adequate sinus drainage followed by medical therapy consists of topical steroids, anti fungal therapy, Immunotherapy, and systemic corticosteroids. Treatment of invasive fungal sinusitis includes surgical resection of necrotic tissues, systemic antifungal therapy and reversal of immune dysfunction.

Allergic fungal sinusitis (AFS) – earlier diagnosis and management

2005 ◽  
Vol 119 (11) ◽  
pp. 875-881 ◽  
Author(s):  
Neeraj Singh ◽  
N H Bhalodiya
Keyword(s):  
Antifungal Therapy ◽  
Statistical Significance ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Intracranial Extension ◽  
Comprehensive Treatment ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling

Aim: To evaluate the criteria for diagnosing allergic fungal sinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of mucosa. Methods: This is a prospective study of 251 patients with chronic rhinosinusitis with or without polyposis, of whom 199 were treated surgically. Mucus sample collection, nasal secretion culture, surgical specimen handling and histological evaluation of surgical specimens are described. The management included wide local endoscopic sinus debridement, adequate sinus aeration, post-operative use of steroids and antifungal therapy. Results: Fungal cultures of nasal secretions were positive in 201 (80.01 per cent) of 251 patients. Of the 199 surgical cases, fungal elements were found in 156 histological specimens (62.1 per cent). Allergic mucin was found in 182 patients (91.45 per cent). Nasal obstruction and proptosis were the commonest presentations. All pre-operative versus post-operative changes in AFS-associated complaints reached statistical significance of p < 0.001. The ethmoid sinus was commonly involved with adjacent lamina papyracea exhibiting demineralization in 26.6 per cent of cases. Intracranial extension was seen in 15 cases. Recurrence was noted in 11 cases. Conclusion: Comprehensive treatment with endoscopic sinus surgery, steroids and antifungal therapy is needed. AFS is readily recurrent. Long-term follow up is important.

scholarly journals A Case of Relapse of Invasive Fungal Sinusitis after Endoscopic Sinus Surgery

2013 ◽  
Vol 137 (0) ◽  
pp. 46-47
Author(s):  
Kenji Noda ◽  
Satoru Kodama ◽  
Hideaki Mabuchi ◽  
Kanako Noda ◽  
Masashi Suzuki
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis

scholarly journals Non-invasive fungal sinusitis resulting in multiple cranial nerve neuropathies

2019 ◽  
Vol 12 (4) ◽  
pp. e229094 ◽  
Author(s):  
Thomas Hendriks ◽  
Samuel Leedman ◽  
Mark Quick ◽  
Aanand Acharya
Keyword(s):  
Schizophyllum Commune ◽  
Invasive Disease ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Upper Respiratory Tract ◽  
Radiological Investigation ◽  
Non Invasive ◽  
Invasive Fungal Sinusitis ◽  
Cranial Neuropathies ◽  
Upper Respiratory

A 33-year-old man presented to the emergency department with a right-sided facial paralysis and maxillary division (V2, trigeminal nerve) paraesthesia. He had been suffering with upper respiratory tract symptoms in the preceding 2 months, including rhinorrhoea, fever and headache. The patient was otherwise fit and immunocompetent. Urgent radiological investigation revealed extensive fungal sinusitis with sphenoid sinus dehiscence and skull base osteitis. The patient underwent emergency endoscopic sinus surgery revealing concretions and debris in the ethmoid and sphenoid sinuses. He was commenced on systemic antifungal therapy and made a full recovery with resolution of his cranial neuropathies. The fungusSchizophyllum communewas isolated and is a rare cause of fungal sinusitis, but with the potential for invasive disease in immunosuppressed individuals.

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