Utilizing CT soft-tissue markers as a screening tool for acute invasive fungal sinusitis

2021 ◽  
Author(s):  
Deepa Susan John ◽  
Karthik Shyam ◽  
Dhilip Andrew ◽  
Soumya Cicilet ◽  
Saikanth Reddy Deepalam
Keyword(s):  
Soft Tissue ◽  
Early Detection ◽  
Nasolacrimal Duct ◽  
Histopathological Diagnosis ◽  
Fungal Sinusitis ◽  
Equal Distribution ◽  
Early Therapy ◽  
Invasive Fungal Sinusitis ◽  
Poor Outcomes ◽  
Contrast Ct

Objectives: Acute invasive fungal sinusitis (AIFS) is a rapidly progressive disease, whose delayed identification results in poor outcomes, especially in immunocompromised individuals. A surge in of AIFS in the wake of the COVID-19 pandemic, has lent additional morbidity and mortality to an already precarious clinical scenario. Early detection of AIFS in individuals who are symptomatic/ at risk can allow early therapy, enabling better patient outcomes. Our study aims to determine optimal soft-tissue markers on CT for the early detection of AIFS. Methods: In this case-control study, 142 patients with equal distribution of subjects were chosen based on histopathological diagnosis of AIFS; and their non-contrast CT scans were retrospectively assessed to determine the diagnostic utility of specific soft-tissue markers that would enable diagnosis of AIFS. Results: A total of 9 markers with adequate sensitivity and specificity were identified, including pterygopalatine and sphenopalatine fossae, inferior orbital fissure and nasolacrimal duct involvement, premaxillary thickening, retro-antral and orbital stranding, and infratemporal muscle edema. It was determined that the combined occurrence of any 3 out of 9 markers was 91.5% sensitive and 95.9% specific for diagnosis of AIFS (p < 0.005). Conclusion: Early, accurate detection of AIFS in predisposed individuals is possible with identification of soft-tissue markers on NECT, enabling early intervention. Advances in knowledge: Being the aggressive disease that it is, AIFS may be managed early if the index of suspicion is held high via CT imaging; which our diagnostic checklist aims at enabling.

A Case of Chronic Invasive Fungal Sinusitis with Invasion of the Nasolacrimal Duct

2017 ◽  
Vol 148 (0) ◽  
pp. 40-41
Author(s):  
Shuta Tomisato ◽  
Sayuri Yamamoto ◽  
Taiji Kawasaki ◽  
Koichirou Wasano
Keyword(s):  
Nasolacrimal Duct ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Chronic Invasive

A Case of Chronic Invasive Fungal Sinusitis with Invasion of the Nasolacrimal Duct

2016 ◽  
Vol 109 (9) ◽  
pp. 637-642
Author(s):  
Shuta Tomisato ◽  
Sayuri Yamamoto ◽  
Taiji Kawasaki ◽  
Koichirou Wasano
Keyword(s):  
Nasolacrimal Duct ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Chronic Invasive

scholarly journals Invasive fungal sinusitis in post COVID ‐19 patients: a new clinical entity

2021 ◽  
Author(s):  
Noha Ahmed El‐Kholy ◽  
Ahmed Musaad Abd El‐Fattah ◽  
Yasser W. Khafagy
Keyword(s):  
Clinical Entity ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis

scholarly journals Soft tissue masses: distribution of entities and rate of malignancy in small lesions

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Felix G. Gassert ◽  
Florian T. Gassert ◽  
Katja Specht ◽  
Carolin Knebel ◽  
Ulrich Lenze ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Benign Lesion ◽  
Maximum Diameter ◽  
Histopathological Diagnosis ◽  
Tumor Diameter ◽  
Mr Images ◽  
Tissue Mass ◽  
Malignancy Rate ◽  
Significant Difference ◽  
Soft Tissue Masses

Abstract Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

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.

Sign in / Sign up

Export Citation Format

Share Document