Frequency of Granulomatous Invasive Fungal Sinusitis in Patients with Clinical Suspicion of Chronic Fungal Rhinosinusitis

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.

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Invasive Fungal Rhinosinusitis: Our Experience

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1005 ◽

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.

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

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i6.1343 ◽

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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Invasive fungal rhinosinusitis in patients with diabetes

The Journal of Infection in Developing Countries ◽

10.3855/jidc.9699 ◽

2018 ◽

Vol 12 (09) ◽

pp. 787-793

Author(s):

Nishant Raizada ◽

Viveka P Jyotsna ◽

Devasenathipathy Kandasamy ◽

Immaculata Xess ◽

Alok Thakar ◽

...

Keyword(s):

Hospital Stay ◽

Care Center ◽

Tertiary Care ◽

North India ◽

Treatment Modalities ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Fungal Rhinosinusitis ◽

Patients With Diabetes ◽

Invasive Fungal Rhinosinusitis

Introduction: We report the clinical and radiological features as well as outcomes of invasive fungal rhinosinusitis in patients with diabetes from a tertiary care center in North India. Methodology: All patients admitted with a diagnosis of invasive fungal rhinosinusitis with pre-existing or newly diagnosed diabetes from 1st January 2008 to 31st December 2015 were included. Hospital records were used to identify clinical features, biochemical investigations and treatment modalities used. The imaging findings were reported at baseline, 30, 60,90 and 120 days of admission and progression of disease was reported as static, worse or improved. The outcomes were sight loss and survival at end of hospital stay. Results: 22 patients of invasive fungal sinusitis and diabetes were identified. At presentation, 5 had ketoacidosis, all of whom died at the end of hospital stay. Loss of vision in one eye was seen in 70% cases. The survival at end of hospital stay was 72.7% and at six months after end of study period was 57.8%. No patients had radiological improvement at day 30 imaging (including those who subsequently improved). Conclusion: Radiological improvement is not apparent before two months of therapy. Ketoacidosis is a predictor of mortality in invasive fungal sinusitis with diabetes.

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Chronic Invasive Fungal Rhinosinusitis in Immunocompetent Patients: A Retrospective Chart Review

Frontiers in Surgery ◽

10.3389/fsurg.2020.608342 ◽

2020 ◽

Vol 7 ◽

Author(s):

Naif H. Alotaibi ◽

Omar Abu Omar ◽

Mays Altahan ◽

Haifa Alsheikh ◽

Fawziah Al Mana ◽

...

Keyword(s):

Chart Review ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Csf Leak ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis ◽

Chronic Invasive ◽

Immunocompetent Patients

Objective: We report cases of Chronic Invasive Fungal Sinusitis (CIFS) in patients considered as immunocompetent at tertiary care center (King Faisal Specialist Hospital), to analyze their clinical, biological, radiological features, and management.Material and methods: A retrospective chart review of CIFS in immunocompetent patients. The inclusion criteria as the following: immunocompetent patients of any age with histopathological findings of CIFS. Immunocompromised patients, acute Invasive Fungal Sinusitis (IFS), non-invasive fungal rhinosinusitis, and no positive histological findings were excluded.Results: Seventeen (17) patients were included. The species isolated included: Aspergillus (most frequent) & Mucor. Surgical treatment approaches were described. Complications reported include CSF leak, blindness, recurrence, and death.Conclusions: Early diagnosis and management of CIFS improve clinical outcomes.

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A rare case of invasive fungal sinusitis by co-infection of two fungi in a post COVID-19 patient: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212906 ◽

2021 ◽

Vol 7 (8) ◽

pp. 1361

Author(s):

Timna Chungath ◽

Deepak Dileep Kumar ◽

Shalu Susan Mathew ◽

Jijo Paul

Keyword(s):

Case Report ◽

Nasal Cavity ◽

Liposomal Amphotericin ◽

Rare Case ◽

Patient Survival ◽

Severe Headache ◽

Fungal Sinusitis ◽

Invasive Fungal Sinusitis ◽

Fungal Rhinosinusitis ◽

Invasive Fungal Rhinosinusitis

<p>Invasive fungal rhinosinusitis is a disease of the paranasal sinuses and nasal cavity that typically affects immunocompromised patients in acute fulminant form. Early symptoms can often mimic rhino sinusitis while late symptoms can cause significant morbidity and mortality. With early diagnosis and treatment can increase the patient survival. This case report is of 73 years old diabetic post COVID-19 patients. The patient presented to us was having severe headache and facial pain confined to left side cheek area with loosening of teeth. The patient underwent nasal cavity and biopsy from the maxillary sinus (left side) under local anaesthesia, which confirmed the diagnosis of invasive fungal sinusitis suggestive of co-infection by 2 fungi, aspergillus flavus and mucor. Further, the patient underwent surgical debridement and started on liposomal amphotericin B and patient improved significantly.</p>

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Histopathological Examination in the Categorization of fungal Rhinosinusitis - a Retrospective Study

Nepalese Medical Journal ◽

10.3126/nmj.v4i2.41377 ◽

2021 ◽

Vol 4 (2) ◽

pp. 478-481

Author(s):

Sangeetha Kandasamy ◽

Megala Chandrasekar ◽

Thamilselvi Ramachadran

Keyword(s):

Clinical Diagnosis ◽

Gold Standard ◽

Nasal Polyps ◽

Histopathological Examination ◽

Clinical Suspicion ◽

Fungal Sinusitis ◽

Medical College ◽

Fungal Rhinosinusitis ◽

Hematoxylin And Eosin ◽

Made In

Introduction: Fungal Rhinosinusitis is broadly defined as any sinonasal pathology related to the presence of fungi and is increasingly recognized worldwide. This study aimed to assess and ascertain the need for histopathological examination in the management of fungal Rhinosinusitis. Materials and Methods: This study was performed over two years, from April 2019 to April 2021, in the Department of Pathology, Vinayaka Missions KirupanandaVariyar Medical College and Hospital, Salem. A total of 383 cases of rhinosinusitis/nasal polyps were studied. Histopathological examination and categorization were done and compared with clinical diagnosis. Results: Only 4/18 cases of acute fungal Rhinosinusitis were correctly diagnosed(22.22%). Nineteen cases of the fungal ball were diagnosed, but none was correctly categorized. Clinical suspicion of fungal sinusitis was present in 10 cases of Rhinosinusitis, which turned out to be chronic Rhinosinusitis in histopathology. In AFRS, fungal elements were overlooked in Hematoxylin and Eosin stained slides and identified only by Grocottmethenamine silver in one-fourth of the cases. Conclusions: Though clinical diagnosis was made in 86% of fungal rhinosinusitis cases, correct categorization was done only in one-third of cases. CT scan could diagnose 60% of cases, but none was categorized. As treatment depends on the type of fungal Rhinosinusitis, histopathological examination is the gold standard for diagnosing and treating fungal Rhinosinusitis.

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Fungal Sinusitis

10.2310/ot.7054 ◽

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

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