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Published on: March 9, 2018
[Acute invasive fungal rhinosinusitis--case report]
Agnieszka Jedrusik1, Anna Galewicz, Antoni Krzeski
1Katedra i Klinika Otolaryngologii AM w Warszawie.
Otolaryngologia Polska = the Polish Otolaryngology
|June 11, 2002
Summary
This case report details a fatal outcome of acute invasive fungal rhinosinusitis in a patient with acute myeloid leukemia despite aggressive treatment. The aggressive fungal infection rapidly progressed, leading to cardiorespiratory failure.
Area of Science:
- Mycology
- Hematology
- Infectious Diseases
Background:
- Acute myeloid leukemia (AML) is a hematologic malignancy that can predispose patients to opportunistic infections.
- Invasive fungal rhinosinusitis (IFR) is a rare but severe complication, particularly in immunocompromised individuals.
Observation:
- A 28-year-old female with AML presented with symptoms suggestive of fungal rhinosinusitis.
- Diagnostic workup included clinical evaluation, nasal endoscopy, CT, MRI, and histopathology, confirming invasive fungal infection.
Findings:
- Despite prompt and aggressive treatment with amphotericin B, antibiotics, and surgical debridement of paranasal sinuses, the patient's condition rapidly deteriorated.
- The underlying AML and the invasive fungal infection progressed concurrently, overwhelming the therapeutic interventions.
Implications:
- This case highlights the critical challenge of managing invasive fungal infections in immunocompromised patients with hematologic malignancies.
- Aggressive multimodal therapy may not always be sufficient to overcome rapidly progressing fungal invasion and underlying disease.
- Early recognition and diagnosis are crucial, but outcomes remain poor in severe, rapidly advancing cases.
