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[Acute fulminant invasive fungal sinusitis]
Ming Liu1, Bing Zhou, Hua-chao Liu
1Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China. mink@eastnet.com.cn
Zhonghua Er Bi Yan Hou Ke Za Zhi
|January 28, 2004
Summary
Early diagnosis and aggressive treatment are crucial for acute fulminant invasive fungal rhinosinusitis (AFFS). Prompt surgical debridement, antifungal therapy, and underlying disease control improve survival rates for this severe fungal infection.
Area of Science:
- Otolaryngology and Infectious Diseases
- Mycology and Medical Imaging
Context:
- Acute fulminant invasive fungal rhinosinusitis (AFFS) is a rare but aggressive infection.
- Diagnosis often relies on a combination of clinical presentation, imaging, and histopathology.
- Underlying conditions like diabetes and leukemia can predispose patients to AFFS.
Purpose:
- To outline the clinical presentation, diagnostic criteria, and treatment principles for AFFS.
- To evaluate the outcomes of surgical and antifungal interventions in AFFS patients.
Summary:
- Six patients with AFFS were diagnosed using clinical, endoscopic, and imaging findings (CT and MRI).
- Fungal species identified included Mucor, Rhizopus, Aspergillus, and Alternaria.
- Treatment involved aggressive surgical debridement, systemic antifungal medications (amphotericin B, itraconazole), and management of comorbidities; outcomes varied, with survival dependent on early intervention and disease control.
Impact:
- Highlights the importance of high clinical suspicion and early endoscopic evaluation for AFFS.
- Emphasizes the critical role of advanced imaging (MRI) in early diagnosis.
- Underscores the necessity of multidisciplinary management including surgery, antifungals, and comorbidity control for improved patient outcomes.