scholarly journals Understanding acute invasive fungal rhinosinusitis for better treatment outcomes

2019 ◽  
Vol 5 (2) ◽  
pp. 383
Author(s):  
Monika Patel ◽  
Maitri Kaushik ◽  
Arun Dehadaray ◽  
Gargi Kar
Keyword(s):  
Early Diagnosis ◽  
Treatment Outcomes ◽  
Tertiary Care ◽  
Good Prognosis ◽  
Surgical Debridement ◽  
Antifungal Treatment ◽  
Cerebral Disease ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background:</strong> Objectives of the study were to identify factors that affect patient survival, determine treatment outcomes in various clinical presentations, increase awareness amongst clinicians and provide more accurate treatment options to patients. Study design was a retrospective study. Study places were Tertiary care centre and a Medical College.</p><p class="abstract"><strong>Methods:</strong> A series of patients diagnosed and treated for acute invasive fungal rhinosinusitis over a period of 7 years.  </p><p class="abstract"><strong>Results:</strong> Twelve patients were reviewed out of which eleven were diabetic. Most common fungus encountered was mucor. Six cases presented as sinonasal disease, four as rhino-orbital disease and two as rhino-orbito-cerebral disease. All the patients underwent surgical debridement with systemic antifungal treatment. It was seen that diseases confined to sino nasal areas had good prognosis. Early diagnosis and prompt intervention is major factor for better prognosis.</p><p class="abstract"><strong>Conclusions:</strong> Immunocompromised patients in ICU with ocular symptoms should be meticulously screened for invasive fungal rhinosinusitis. Early diagnosis and prompt management with surgical debridement and systemic antifungal treatment is utmost important factor in good prognosis. Intensivists and also the physicians should be made cognizant as they play important role in patient management as well. Multidisciplinary approach is the need of hour.</p>

Acute Invasive Fungal Rhinosinusitis in Immunocompromised Patients: Role of an Early Diagnosis

2018 ◽  
Vol 159 (2) ◽  
pp. 386-393 ◽  
Author(s):  
Ignacio Javier Fernandez ◽  
Francesco Maria Crocetta ◽  
Marco Demattè ◽  
Paolo Farneti ◽  
Marta Stanzani ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Early Diagnosis ◽  
Treatment Protocol ◽  
University Hospital ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Time Required ◽  
The University ◽  
The Impact ◽  
Invasive Fungal Rhinosinusitis

Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy. Subjects and Methods The impact of time to treatment and clinical, pathologic, and microbiological variables were analyzed among patients with histologically and microbiologically proven AIFRS. The outcomes of patients treated before the introduction of the early diagnosis protocol were compared with those treated afterward. Results Nineteen patients affected by AIFRS were eligible for the study. Treatment delay >4 days ( P = .002), infection caused by Mucorales ( P = .015), and extension of the disease were negative prognostic variables ( P = .017). The application of our protocol significantly reduced the delay for diagnosis and appropriate treatment by an average of 7.3 days ( P = .02). Conclusion The promptness of the diagnosis and surgical treatment may play a significant role in the management of AIFRS, as it appears to be significantly associated with the disease outcome. Our protocol may help to reduce the time required for diagnosis of high-risk hematologic patients.

scholarly journals Clinicoepidemiological study of acute invasive fungal rhinosinusitis in a tertiary care centre

2021 ◽  
Vol 7 (11) ◽  
pp. 1772
Author(s):  
Rajeshree Chaurpagar ◽  
Priyanka Garud ◽  
Apurva Pawde ◽  
Parag Doifode ◽  
Bhagyashree Chiplunkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care ◽  
World Health ◽  
High Morbidity ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
History Of ◽  
Invasive Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) accounted for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was declared a global pandemic by World health organization (WHO) in March 2020. In second wave of COVID there was notable surge in Acute invasive fungal rhinosinusitis (AIFRS). We observed that use of systemic corticosteroids in treatment of COVID 19 especially among patients with poorly controlled diabetes mellitus increased the incidence of AIFRS.</p><p class="abstract"><strong>Methods:</strong> This is retrospective observational study carried out in a Tertiary care Hospital GMC Akola from period of February 2021 to august 2021 were patients with the suspected diagnosis of AIFRS were admitted and evaluated following a standardized protocol, including clinical examination diagnostic nasal endoscopy, radiological evaluation. Diagnosis of AIFRS was confirmed on histopathology.</p><p class="abstract"><strong>Results:</strong> Study was conducted in GMC, Akola of 136 patients out of which 97 were males and 39 were females. In our study 78.67% patients had history of covid infection, followed by diabetes mellitus in 54.41%, history of steroid treatment found in 64.70% patients. On HPE 69.85% were positive for mucor and mixed infection (mucor and aspergillus) were found in 6.61%. Most common presenting feature was facial pain and swelling in 66.91%, palatal changes with dental pain in 45.58%, diminution of vision 17.64%, headache in 27.94% patients.</p><p><strong>Conclusions:</strong> Early and prompt diagnosis in high level of clinical suspicion in suspicious patient of AIFRS is vital to improve outcomes as it is known to have high morbidity and mortality (18-80%).</p>

scholarly journals Treatment outcomes in acute invasive fungal rhinosinusitis extending to the extrasinonasal area

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sung Hoon Nam ◽  
Yoo-Sam Chung ◽  
Young Jun Choi ◽  
Jeong Hyun Lee ◽  
Ji Heui Kim
Keyword(s):  
Treatment Outcomes ◽  
Fungal Rhinosinusitis ◽  
Acute Invasive Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis

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
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