[Severe nasosinus aspergillosis in immunosuppressed patients. Apropos of 3 cases]

J M Juvanon1, M Feuilhade de Chauvin, I S Delacour

  • 1Service d'ORL et de Chirurgie Cervico-faciale, Hôpital intercommunal, Créteil.

Insights

Nasosinusal lesions caused by Aspergillus are rare but severe during immunosuppressive chemotherapy. Aggressive surgical intervention may be necessary for survival, as seen in one of three reported cases.

Area of Science:

  • Mycology
  • Oncology
  • Otolaryngology

Background:

  • Immunosuppressive chemotherapy can predispose patients to opportunistic fungal infections.
  • Invasive Aspergillus infections of the nasosinusal region are uncommon but carry a high mortality rate.

Observation:

  • Three cases of nasosinusal lesions caused by Aspergillus in patients undergoing immunosuppressive chemotherapy are presented.
  • These lesions led to extensive necrotizing mucoperiostitis of the facial bones.

Findings:

  • The infection is extremely grave, with a high fatality rate.
  • One patient recovered after radical surgery, including orbital exenteration and dural denudation.

Implications:

  • Early recognition and aggressive management are crucial for improving outcomes.
  • Surgical intervention, despite its morbidity, may be life-saving in selected cases.
  • Further research into preventative strategies and novel treatments is warranted.

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