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Aspergillus sinusitis in patients with AIDS: report of three cases and review
W Teh1, B S Matti, H Marisiddaiah
1Division of Allergy, Clinical Immunology, and Infectious Diseases, St. Luke's/Roosevelt Hospital Center, New York, New York 10025, USA.
Abstract:
Invasive aspergillosis is an uncommon but increasingly reported complication of AIDS. Sinusitis, usually bacterial in etiology, is frequently seen among human immunodeficiency virus (HIV)-infected patients. We discuss the cases of three patients with AIDS and invasive aspergillus sinusitis seen at our institutions and those of 15 patients who are described in the literature. Seven of the 18 had brain involvement, 3 had orbital involvement, and 7 had mastoid or other bony disease. Three had evidence of concomitant invasive pulmonary aspergillosis. Of 15 patients with evaluable histories, 11 had recognized risks for invasive aspergillosis; 6 had previous sinusitis, otitis, or polyposis; and 11 had prior conditions indicative of advanced HIV-related disease. Despite aggressive surgical intervention and systemic antifungal therapy, nearly all patients died as a result of aspergillosis.
Insights
Invasive aspergillosis, a fungal infection, is a rare but growing complication in AIDS patients, often affecting the sinuses. This study highlights the severe outcomes of invasive aspergillus sinusitis in HIV-infected individuals.
Area of Science:
- Infectious Diseases
- Mycology
- Immunocompromised Hosts
Background:
- Sinusitis is common in HIV-infected patients, typically bacterial.
- Invasive aspergillosis is an uncommon but increasingly reported complication of Acquired Immunodeficiency Syndrome (AIDS).