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Related Experiment Videos

Fungal sinusitis in immunocompromised children with neoplasms.

K T Kavanagh1, W T Hughes, D M Parham

  • 1Department of Otolaryngology, University of Tennessee, Memphis 38163.

The Annals of Otology, Rhinology, and Laryngology
|April 1, 1991
PubMed
Summary

Fungal sinusitis is common in leukemia patients undergoing chemotherapy. Early treatment with amphotericin B and surgery improves survival, but relapse remains fatal.

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Area of Science:

  • Medical Mycology
  • Pediatric Oncology
  • Infectious Diseases

Background:

  • Fungal sinusitis presents diagnostic and therapeutic challenges in immunocompromised pediatric patients.
  • Hematopoietic neoplasms are associated with a higher incidence of sinusitis compared to solid tumors.

Purpose of the Study:

  • To review the diagnosis and treatment of fungal sinusitis in immunocompromised patients at St Jude Children's Research Hospital.
  • To evaluate the efficacy of an aggressive treatment strategy for invasive fungal sinusitis.

Main Methods:

  • Retrospective review of pediatric patients with fungal sinusitis.
  • Analysis of clinical findings, treatment protocols, and outcomes.
  • Correlation of neutrophil counts and chemotherapy status with disease progression.

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Main Results:

  • Fungal sinusitis was identified in 8 patients undergoing chemotherapy for acute leukemia with low neutrophil counts.
  • Common symptoms included fever, facial pain, and abnormal sinus radiographs.
  • Surveillance cultures were unreliable predictors of sinus pathogens.
  • An aggressive treatment approach involving amphotericin B and surgical drainage yielded an 80% survival rate in patients in remission on maintenance chemotherapy.

Conclusions:

  • Fungal sinusitis requires prompt diagnosis and aggressive management in immunocompromised children, particularly those with leukemia.
  • Early administration of amphotericin B and surgical intervention are crucial for improving survival rates.
  • Patients undergoing chemotherapy for relapse have a poor prognosis, highlighting the importance of remission-based treatment.