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.

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

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 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>

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.

Functional Endoscopic Sinus Surgery in the Immunocompromised Child

1991 ◽  
Vol 105 (6) ◽  
pp. 818-825 ◽  
Author(s):  
Brian J. Wiatrak ◽  
Paul Willging ◽  
Charles M. Myer
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Fatal Outcome ◽  
Chemotherapeutic Agents ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Sinus Disease ◽  
Immunocompromised Child ◽  
Surgical Modality ◽  
Sinonasal Disease

Fungal sinusitis in the immunocompromised child is an aggressive, invasive process that may result in a fatal outcome if not diagnosed early. As a result of increasing use of bone marrow transplantation and new cytotoxic chemotherapeutic agents resulting in severe agranulocytopenia, more patients have become susceptible to fungal sinus disease. Functional endoscopic sinus surgery has emerged recently as an important surgical modality in the treatment of sinus disease in adults and children. Use of this technique in immunosuppressed children has allowed early diagnosis of fungal sinonasal disease, resulting in earlier surgical intervention. The high-quality fiberoptic capability of nasal endoscopes allows very detailed visualization of the internal anatomy of the nose and detects early mucosal changes as a result of intranasal fungal disease. Our experience using functional endoscopic sinus surgery in immunocompromised children over an 18-month period is reviewed. Our philosophy for diagnosis and management of immunocompromised children with suspected fungal sinonasal disease is discussed.

scholarly journals Outcomes of endoscopic sinus surgery for sinusitis-induced intracranial abscess in patients undergoing neurosurgery

2019 ◽  
Vol 47 (2) ◽  
pp. E12 ◽  
Author(s):  
Megumi Koizumi ◽  
Miho Ishimaru ◽  
Hiroki Matsui ◽  
Kiyohide Fushimi ◽  
Tatsuya Yamasoba ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Length Of Stay ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Neurosurgical Procedures ◽  
Fungal Sinusitis ◽  
Intracranial Abscess ◽  
Diagnosis Procedure Combination ◽  
Intracranial Complications ◽  
Orbital Complications

OBJECTIVEAlthough sinusitis-induced intracranial complications rarely occur in the current era of antibiotics, they can induce neurological symptoms or death. The authors of this study investigated the association between endoscopic sinus surgery (ESS) and outcomes in patients who had undergone neurosurgical procedures for sinusitis-induced intracranial abscess.METHODSThe authors obtained data on patients with sinusitis-induced intracranial abscess from the Japanese Diagnosis Procedure Combination inpatient data for the period from 2010 to 2017. They excluded patients with fungal sinusitis, orbital complications, immunodeficiency, and malignant disease. They also excluded patients who had received antifungal agents, chemotherapy, immunosuppressants, and antidiabetic drugs. Eligible patients were divided into those with and those without neurosurgical procedures. Propensity score–adjusted regression analyses were performed to examine the association between ESS within the same hospitalization and outcomes (mortality, blood transfusion, readmission, revision neurosurgery, and length of stay).RESULTSOf the 552 potentially eligible patients, 255 were treated with neurosurgical procedures, including 104 who underwent ESS within the same hospitalization and 151 who did not. ESS was not significantly associated with mortality (OR 0.54, 95% CI 0.05–5.81, p = 0.61), blood transfusion (OR 1.95, 95% CI 0.84–4.51, p = 0.12), readmission (OR 0.86, 95% CI 0.34–2.16, p = 0.75), revision neurosurgery (OR 0.65, 95% CI 0.24–1.74, p = 0.39), or length of stay (percent difference −10.8%, 95% CI −24.4% to 5.1%, p = 0.18).CONCLUSIONSThe present study suggests that ESS may not have significant benefits with respect to reducing mortality, blood transfusion, readmission, revision neurosurgery, or length of stay.

Correlation between Preoperative Clinical Diagnosis and Histopathological Findings in Patients with Rhinosinusitis

2005 ◽  
Vol 19 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Nicolas Y. Busaba ◽  
Luciano Vilela de Oliveira ◽  
David L. Kieff
Keyword(s):  
Chronic Rhinosinusitis ◽  
Clinical Diagnosis ◽  
Endoscopic Sinus Surgery ◽  
Preoperative Diagnosis ◽  
Case Series ◽  
Sinus Surgery ◽  
Histopathological Diagnosis ◽  
Fungal Sinusitis ◽  
Chronic Invasive ◽  
Type Of Surgery

Background The diagnosis of chronic rhinosinusitis (CRS) or chronic rhinosinusitis with polyposis (CRSP) is typically clinical and based on the combination of medical history, physical examination, and imaging. The recommendation to perform surgery and the type of surgery is tailored to the diagnosis. The objective of this study is to determine the accuracy of preoperative clinical CRS or CRSP diagnosis in patients who underwent endoscopic sinus surgery. Methods This is a retrospective review of a case series of 380 consecutive patients who underwent endoscopic sinus surgery for the preoperative clinical diagnosis of CRS or bilateral CRSP. Data regarding symptoms, nasal endoscopy, computed tomography findings, preoperative diagnosis, and postoperative histopathology results were collected. Results The preoperative diagnoses were CRS (n = 180) and CRSP (n = 200). Two of the 180 patients (1.1%) with the preoperative diagnosis of CRS had a different postoperative histopathological diagnosis. The histopathology in both patients showed noncaseating granulomata, leading to a diagnosis of sarcoidosis. Nine of the 200 patients (4.5%) with the preoperative diagnosis of CRSP had a different postoperative histopathological diagnosis. Of these nine patients, five had inverted papilloma (bilaterally in one instance); one had adenocarcinoma; one had squamous-cell carcinoma; one had chronic invasive granulomatous fungal sinusitis; and one had sinonasal sarcoidosis. Conclusion The preoperative clinical diagnosis can be inaccurate in patients with CRS and bilateral CRSP. The misdiagnosis is more common in CRSP, including patients with recurrent polyposis.

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