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Pediatric Invasive Fungal Rhinosinusitis: A Comprehensive Analysis of Prognostic Factors for Survival
Vijay A Patel1, Christopher D LePhong2, Beth Osterbauer1
1Division of Otolaryngology - Head and Neck Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
The Laryngoscope
|July 25, 2022
Summary
Prognostic factors for pediatric invasive fungal rhinosinusitis (IFS) survival were identified. Aggressive surgical intervention and prompt medical therapy improve outcomes in immunocompromised children with IFS.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Mycology
Background:
- Pediatric invasive fungal rhinosinusitis (IFS) is a severe infection primarily affecting immunocompromised children.
- Identifying prognostic factors is crucial for improving survival rates in this vulnerable population.
Purpose of the Study:
- To determine clinical features that predict survival in pediatric patients diagnosed with IFS.
- To analyze the impact of various treatment modalities on patient outcomes.
Main Methods:
- A retrospective review of pediatric patients with histopathologically confirmed IFS was conducted between 1990 and 2021.
- Clinical data were collected to calculate 6-month and 1-year survival rates.
- Statistical analysis was performed to identify prognostic indicators.
Main Results:
- Eighteen pediatric patients were analyzed; 83.3% were neutropenic, and 55.6% had acute lymphoblastic leukemia.
- Survival rates at 6 months and 1 year were 47.6% and 41.7%, respectively.
- Positive prognostic factors included gross total resection, number of antifungals, and total operations; negative factors included altered mental status, cerebral involvement, cranial neuropathies, hyperglycemia, and ICU status.
Conclusions:
- Gross total resection, adequate antifungal therapy, and surgical intervention are associated with improved survival in pediatric IFS.
- Early diagnosis and prompt, aggressive management are critical for enhancing outcomes in these complex cases.
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