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Invasive fungal rhinosinusitis in immunocompromised patients
Wilma T Anselmo-Lima1, Rony P Lopes, Fabiana C P Valera
1Department of Otorhinolaryngology, Ophthalmology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brasil. mcecilia@hcrp.fmrp.usp.br
Introduction:
Invasive fungal rhinosinusitis (IFR) is one of the most important causes of morbidity and mortality in immunocompromised patients, principally those with cellular immunodeficiency, with mortality ranging from 50 to 80%. Prophylaxis and early diagnosis increase the chances of successful treatment.
Study Design:
Clinical prospective randomized study.
Aim:
To present cases of IFR and to compare them with data reported in the literature.
Material And Methods:
Analysis of eleven cases of IFR confirmed by pathologist examination.
Results:
Aspergillus was found to be the most prevalent pathogen. Symptoms ranged from high fever in most cases to nasal discharge, ulceration of the nasal mucosa, headache and periorbital edema.
Conclusion:
The combination of amphotericin B and endoscopic surgery, associated or not with Caldwell-Luc surgery, showed good results. The use of liposomal amphotericin B also presented a satisfactory outcome.
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