Sinonasal aspergillosis in immunocompetent Indian children: an eight-year experience
A K Gupta1, S Ghosh, A K Gupta
1Department of Otolaryngology and Department of Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. akgpgi@hotmail.com
Insights
Paranasal aspergillosis in children often presents with facial deformity and orbital issues. Surgical intervention is common, with recurrence managed by further surgery and antifungal treatments.
Area of Science:
- Otolaryngology
- Pediatric Mycology
- Medical Mycology
Background:
- Paranasal aspergillosis is a fungal infection affecting the sinuses.
- While often seen in immunocompromised individuals, it can occur in healthy children.
- This condition can lead to significant facial and orbital complications.
Purpose of the Study:
- To describe the clinical characteristics, diagnosis, and management of paranasal aspergillosis in a cohort of healthy children.
- To analyze the outcomes of surgical and antifungal treatments for this pediatric population.
Main Methods:
- A retrospective study of 40 otherwise healthy children diagnosed with paranasal aspergillosis.
- Review of clinical presentations, diagnostic findings (serology, culture, histopathology), surgical interventions, and treatment outcomes.
- Analysis of demographic data, focusing on age and affected sinus
Main Results:
- The study included 40 children, with 15% under 10 years old.
- Common clinical features included facial deformity (100%), orbital involvement (52.5%), and skull base erosion (12.5%).
- The ethmoid sinus was most frequently affected. Aspergillus serology was positive in 35%, and fungal cultures in 40%. Histopathology confirmed non-invasive fungal infections.
Conclusions:
- Paranasal aspergillosis in healthy children typically presents with significant facial and orbital involvement.
- Surgical management is the primary treatment, with a 15% recurrence rate effectively managed by revision surgery and antifungal therapy.
Abstract:
A retrospective study of 40 otherwise healthy children suffering from paranasal aspergillosis is presented. Fifteen percentage of this group was under 10 years of age. The clinical characteristics were marked facial deformity, orbital involvement (52.5%) and skull base erosion (12.5%). Ethmoid sinus was the commonest sinus to be affected. Aspergillus serology was positive in 35% and fungal culture grew the organism in 40%. Histopathology revealed allergic or non-invasive fungal infections without any tissue invasions. Surgery was performed in all except one case. Recurrence was 15% treated by revision surgery and antifungal therapy.
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