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Recurrent Pseudallescheria boydii sinusitis in acute leukemia
A P Grigg1, P Phillips, S Durham
1Leukemia/Bone Marrow Transplantation Program of British Columbia, Vancouver General Hospital, Canada.
Abstract:
Most episodes of fungal sinusitis in immunocompromised patients are caused by Aspergillus species. To treat such infections, surgical debridement and anti-fungal therapy have been recommended; it is also clear however that an adequate neutrophil count is important in controlling such infections. We report a case in which fungal sinusitis was shown to be due to P. boydii and in which the infection recurred over a period of 2 years during episodes of neutropenia in spite of vigorous surgical and medical therapy.
Insights
Fungal sinusitis in immunocompromised patients, often Aspergillus, requires neutrophils. This case highlights recurrent Pseudallescheria boydii sinusitis during neutropenia despite aggressive treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Immunology
Background:
- Fungal sinusitis is a significant concern in immunocompromised individuals.
- Aspergillus species are the most common fungal pathogens implicated.
Observation:
- A case of fungal sinusitis caused by Pseudallescheria boydii (P. boydii) is presented.
- The patient experienced recurrent sinusitis over two years, coinciding with episodes of neutropenia.
Findings:
- Despite comprehensive surgical and antifungal treatment, the P. boydii sinusitis persisted.
- Neutropenia was a critical factor in the recurrence of infection.
Implications:
- This case underscores the importance of adequate neutrophil counts in managing fungal sinusitis in immunocompromised patients.
- It suggests that P. boydii may be a challenging pathogen in neutropenic individuals, requiring tailored treatment strategies.