scholarly journals Chronic Granulomatous Invasive Fungal Sinusitis: A Case Series and Literature Review

2020 ◽  
pp. 014556132090462
Author(s):  
Ibrahim Alarifi ◽  
Saad Alsaleh ◽  
Saleh Alqaryan ◽  
Hassan Assiri ◽  
Mohammed Alsukayt ◽  
...  
Keyword(s):  
Case Series ◽  
Invasive Disease ◽  
Fungal Species ◽  
Fungal Sinusitis ◽  
Pertinent Literature ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Treatment Plans ◽  
Fungal Stain

Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species ( Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

Fungal Sinusitis

2021 ◽  
Author(s):  
Sean P McKee ◽  
Jeffrey Paul Radabaugh ◽  
Martin J Citardi ◽  
William C Yao
Keyword(s):  
Key Words ◽  
Paranasal Sinuses ◽  
Fungal Disease ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Allergic Mucin

Fungal sinusitis encompasses a spectrum of fungal disease processes affecting the paranasal sinuses, ranging from asymptomatic colonization to rapidly progressive and fatal infections. This review contains 10 figures, 3 tables, and 30 references.  Key Words: fungal sinusitis, mycetoma, allergic fungal rhinosinusitis, invasive fungal sinusitis, mucormycosis, allergic mucin

scholarly journals Allergen Immunotherapy in an HIV+ Patient with Allergic Fungal Rhinosinusitis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
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 ◽  
Invasive 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.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

Allergic fungal rhinosinusitis with skull base and orbital erosion

2009 ◽  
Vol 124 (2) ◽  
pp. 161-165 ◽  
Author(s):  
M S Marfani ◽  
M A Jawaid ◽  
S M Shaikh ◽  
K Thaheem
Keyword(s):  
Skull Base ◽  
Sinus Surgery ◽  
Common Finding ◽  
Nasal Discharge ◽  
Topical Steroids ◽  
Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Postnasal Drip ◽  
Imaging Results

AbstractIntroduction:Allergic fungal rhinosinusitis is a benign, noninvasive sinus disease related to hypersensitivity to fungal infection having bony skull base and orbital erosion as common finding.Patients and method:This descriptive study was conducted at the department of otorhinolaryngology, Dow University of Health Sciences, Karachi, Pakistan, from April 2003 to March 2006. In forty-seven proven cases of allergic fungal sinusitis the following information was recorded: demographic data, signs and symptoms, laboratory investigation results, imaging results, pre- and post-operative medical treatment, surgery performed, follow up, and residual or recurrent disease. The Statistical Package for the Social Sciences version 10.0 software was used for data analysis.Results:Findings indicated that allergic fungal rhinosinusitis usually occurred in the second decade of life (51.06 per cent) in males (70.21 per cent), allergic rhinitis (100 per cent) and nasal polyposis (100 per cent). Nasal obstruction (100 per cent), nasal discharge (89.36 per cent), postnasal drip (89.36 per cent), and unilateral nasal and paranasal sinus involvement (59.57 per cent) were significant features. Aspergillus (59.57 per cent) was the most common aetiological agent. Combined orbital and skull base erosion was seen in 30.04 per cent of cases, with male preponderance 6.8:1. Endoscopic sinus surgery was performed in all cases, and recurrent or residual disease was observed in 19.14 per cent.Conclusion:Allergic fungal rhinosinusitis is a disease of young, immunocompetent individual. Skull base and orbital erosion are seen in one-third of cases. Bone erosion is 6.8 times more common in males than females. Orbital erosion is 1.5 times more common than skull base erosion. Endoscopic surgical debridement and drainage combined with topical steroids leads to resolution of disease in the majority of cases, without resorting to systemic antifungal agents, craniotomy or dural resection.

scholarly journals Recurrence Pattern and Complication Rate of Allergic Fungal Sinusitis: A 10-Year Tertiary Center Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yazeed Alghonaim ◽  
Abdulrhman Alfayez ◽  
Riyadh Alhedaithy ◽  
Abdullah Alsheikh ◽  
Malak Almalki
Keyword(s):  
Chronic Rhinosinusitis ◽  
Recurrence Rate ◽  
Nasal Obstruction ◽  
Recurrent Disease ◽  
Disease Recurrence ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Bilateral Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

Background. Allergic fungal rhinosinusitis is a noninvasive form of highly recurrent chronic rhinosinusitis. Despite the advancement in medical and surgical strategies, recurrence in AFRS in general poses another challenging problem with reported incidence that eventually can reach more than 60%. Recognition and understanding the pattern of disease recurrence will lead to greater understanding of the disease response in our population. Method. A retrospective cohort study was performed in King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with chronic rhinosinusitis and underwent functional endoscopic sinus surgery from the period of January 2006 to December 2016 were reviewed. Results. 28 patients were found to have AFRS based on clinical, radiological, and microscopic examination suggestive of allergic fungal rhinosinusitis. Among these patients, 53% of them were female and 46% were male. The age ranged from 13 to 55 years, with a mean age of 31.57 years. 28.57% of the patients presented with recurrent allergic fungal sinusitis. The duration between the surgery and symptoms recurrence was around one year. Male and female patients had similar recurrence rate (50%). At first visit, 95% of the patients with nonrecurrent disease presented with nasal obstruction compared to 87.5% of the patients with recurrent disease. On the other hand, patients with recurrent disease had more nasal discharge (87.5%), postnasal drip (37.5%), facial pressure/pain (50%), headache (50%), nasal polyposis (87.5%), hypertrophy of inferior turbinate (37.5%), and proptosis (12.5%). Nasal obstruction (87.5%) and nasal polyps (87.5%) were the most common presenting symptoms for the disease recurrence. The pattern of disease recurrence in the previously unilateral disease was 18% ipsilateral and 27% bilateral. For the patients who had bilateral disease formerly, 17% (n = 3) of them had recurrent bilateral disease. Conclusion. Allergic fungal rhinosinusitis is a distinct clinical entity. A high recurrence rate is a pathognomonic feature of the disease, despite all the development in medical and surgical trials. This study demonstrated that recurrence rate is lower in our population. However, more studies with a greater number of patients are needed in the future to clearly recognize the pattern of recurrence in patients with AFRS.

scholarly journals Relation between Complicated Allergic Fungal Rhinosinusitis and the Mycological Profile of the Isolated Fungal Species

2021 ◽  
Vol 85 (1) ◽  
pp. 2897-2892
Author(s):  
Awatef Mahmoud Ahmed ◽  
Ibrahim Rezk Mohamed ◽  
Abeer Sheneef Mohamed ◽  
Mohammed Abdel-Kader Ahmed ◽  
Ahmed Ismail
Keyword(s):  
Fungal Species ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

scholarly journals Noninvasive fungal rhinosinusitis: a case series

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 869
Author(s):  
Mohamed Masmoudi ◽  
Jihene Chelli ◽  
Asma Ben Mabrouk ◽  
Ezer Chebil ◽  
Wadii Thabet ◽  
...  
Keyword(s):  
Case Series ◽  
University Hospital ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Management Protocol ◽  
Middle Meatal Antrostomy ◽  
Definition Of ◽  
Histopathological Results ◽  
The University

Introduction: Fungal rhinosinusitis (FRS) remains a rare disease. The noninvasive forms are hard to diagnose. The management protocols remain controversial. We aim to describe the clinical, radiological and pathological features of noninvasive FRS and present our management protocol and follow-up results. Patients and methods: This descriptive study was conducted in the ear-nose-throat department of the university hospital, Taher Sfar in Mahdia, Tunisia. All patients who responded to the definition of noninvasive FRS (fungal balls and allergic fungal sinusitis) were included. The study was conducted over a three year period (May 2017 – April 2021). Results: Eleven patients were included in this study: four cases of fungal balls and seven cases of allergic fungal sinusitis. Patients presented with symptoms of chronic recurrent rhinosinusitis with no response to conventional treatments. Computed tomodensitometry scan showed opacification of the paranasal sinuses in all patients. Other signs were heterogeneous opacities, local calcifications and thinning of the bony walls of the sinuses. Histopathological findings were inflammatory polyps in all cases of allergic FRS with the presence of fungal hyphae in 42.8% of the cases. All patients underwent surgery after a median delay of 12 [6–24] months of the symptom’s onset. The used procedures were endoscopic middle meatal antrostomy for all patients, ethmoidectomy (81.8%) and sphenoidotomy (36.4%). None received systemic antifungals or corticosteroids with a favorable outcome in all cases. Conclusion: Symptoms of noninvasive FRS are nonspecific. The scan images contribute to the diagnosis, but the perioperative findings and the histopathological results remain crucial.  The management is mainly surgical.

scholarly journals Invasive Fungal Rhinosinusitis: Our Experience

2009 ◽  
Vol 2 (3) ◽  
pp. 21-26
Author(s):  
Kapil Dua ◽  
H Chopra ◽  
Neha Chopra ◽  
Sanjeev Puri ◽  
Vikrant Mittal
Keyword(s):  
Facial Pain ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Immunocompromised Patient ◽  
Fungal Sinusitis ◽  
Adequate Treatment ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Endemic Mycoses ◽  
Invasive Fungal Rhinosinusitis

Abstract Opportunistic fungal infections in immunocompromised patients are associated with a high mortality rate. Endemic mycoses are often asymptomatic, but in appropriate hosts, fungi can cause severe and even fatal infection. Facial pain in an immunocompromised patient may signify invasive fungal sinusitis. Treatment with antifungal agents needs to be individualized according to factors such as the type of fungus, presence of renal failure, or pregnancy. Combining antifungal agents or addition of other approaches, such as surgical debridement or steps to control intracranial pressure, may be needed for adequate treatment of certain types of fungal infections.

TO DETERMINE THE VARIOUS CLINICAL PRESENTATIONS, UNDERLYING IMMUNOCOMPROMISED CONDITION, COMPLICATION OF ACUTE INVASIVE FUNGAL RHINOSINUSITIS (AIFRS): AN OBSERVATIONAL STUDY.

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Abhiniti . ◽  
Pawan Kumar Lal
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Sinus Thrombosis ◽  
Fungal Sinusitis ◽  
Cavernous Sinus Thrombosis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Clinical Presentations ◽  
Invasive Fungal Rhinosinusitis

Aim: to determine the various clinical presentations, underlying immune-compromised condition, complication of acute invasive fungal rhinosinusitis (AIFRS). Materials and Methods: The present prospective observational study was conducted in the Department of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar, India. Among 40 patients of acute invasive fungal sinusitis that underwent treatment as inpatient basis. Nasal swabs from the middle meatus were subjected to potassium hydroxide mount and if fungal elements were identified, then fungal culture was done. Post-operatively, tissue removed from the sinuses was sent for histopathological examinations. Results: majority of the patients were male 57.5% and rest 42.5% were female. Patients having Diabetes Mellitus were found to be more susceptible to acute and invasive fungal sinusitis. The common presenting symptoms were nasal obstruction followed by rhinorrhea, epistaxis, headache, fever, facial swelling. Most common complication reported in this study was Cavernous sinus thrombosis 11 (27.5%). Conclusion: acute invasive fungal sinusitis is most common in immunocompromised patients, with the highest incidence in patients with uncontrolled diabetes mellitus. The most consistent finding of acute invasive fungal sinusitis was mucosal necrosis and black crust/debris. Keywords: acute invasive fungal sinusitis, diabetes mellitus, cavernous sinus thrombosis

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