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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
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Intermediate Invasive Fungal Sinusitis, a Distinct Entity From Acute Fulminant and Chronic Invasive Fungal Sinusitis.

Andre J Burnham1, Kelly R Magliocca2, Brian Pettitt-Schieber3

  • 1School of Medicine, Emory University, Atlanta, GA, USA.

The Annals of Otology, Rhinology, and Laryngology
|October 25, 2021
PubMed
Summary
This summary is machine-generated.

A new intermediate invasive fungal sinusitis (IFS) classification is proposed for patients not fitting acute (aIFS) or chronic (cIFS) criteria. This distinct subgroup requires further investigation due to severe presentations and high mortality rates.

Keywords:
angioinvasionclassificationfungus ballintracranial invasioninvasive fungal sinusitissinusitis

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Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Pathology

Background:

  • Current invasive fungal sinusitis (IFS) classification includes acute (aIFS) and chronic (cIFS) phenotypes.
  • These phenotypes differ in symptom onset, angioinvasion, necrosis extent, and disease progression.
  • A subset of IFS patients presents with characteristics not aligning with aIFS or cIFS.

Purpose of the Study:

  • To define the demographic, clinical, and histopathologic features of a distinct IFS patient subset.
  • To investigate a new entity of invasive fungal disease within the sinusitis spectrum.

Main Methods:

  • Retrospective review of 8 IFS patients from 2010-2020.
  • Classification based on symptom duration: ≤4 weeks (aIFS), ≥12 weeks (cIFS), and 4-12 weeks (new entity).
  • Analysis of clinical presentation, histopathology, and advanced imaging (CT/MRI).

Main Results:

  • The identified subgroup had a mean symptom duration of 50.5 days, with 50% being immunosuppressed.
  • Common symptoms included facial pain, vision changes, and blindness; 25% of patients died.
  • Fungal involvement extended to sinuses, orbital apex, optic nerve, and skull base, with varied histopathologic findings.

Conclusions:

  • Proposing 'intermediate invasive fungal sinusitis' as a novel subgroup.
  • This group exhibits severe disease and requires distinct classification.
  • Further research is needed to understand and manage this intermediate IFS category.