Fungal Sinusitis

2021 ◽  
Author(s):  
Sean P McKee ◽  
Jeffrey Paul Radabaugh ◽  
Martin J Citardi ◽  
William C Yao
Keyword(s):  
Key Words ◽  
Paranasal Sinuses ◽  
Fungal Disease ◽  
Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Allergic Mucin

Fungal sinusitis encompasses a spectrum of fungal disease processes affecting the paranasal sinuses, ranging from asymptomatic colonization to rapidly progressive and fatal infections. This review contains 10 figures, 3 tables, and 30 references.  Key Words: fungal sinusitis, mycetoma, allergic fungal rhinosinusitis, invasive fungal sinusitis, mucormycosis, allergic mucin

scholarly journals Allergen Immunotherapy in an HIV+ Patient with Allergic Fungal Rhinosinusitis

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ian A. Myles ◽  
Satyen Gada
Keyword(s):  
Allergen Immunotherapy ◽  
Severe Infection ◽  
Invasive Fungal Disease ◽  
Fungal Disease ◽  
Fungal Sinusitis ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Invasive Fungal Rhinosinusitis ◽  
Chronic Invasive

Patients with HIV/AIDS can present with multiple types of fungal rhinosinusitis, fungal balls, granulomatous invasive fungal rhinosinusitis, acute or chronic invasive fungal rhinosinusitis, or allergic fungal rhinosinusitis (AFRS). Given the variable spectrum of immune status and susceptibility to severe infection from opportunistic pathogens it is extremely important that clinicians distinguish aggressive fungal invasive fungal disease from the much milder forms such as AFRS. Here we describe a patient with HIV and AFRS to both remind providers of the importance of ruling out invasive fungal disease and outline the other unique features of fungal sinusitis treatment in the HIV-positive population. Additionally we discuss the evidence for and against use of allergen immunotherapy (AIT) for fungal disease in general, as well as the evidence for AIT in the HIV population.

scholarly journals Chronic Granulomatous Invasive Fungal Sinusitis: A Case Series and Literature Review

2020 ◽  
pp. 014556132090462
Author(s):  
Ibrahim Alarifi ◽  
Saad Alsaleh ◽  
Saleh Alqaryan ◽  
Hassan Assiri ◽  
Mohammed Alsukayt ◽  
...  
Keyword(s):  
Case Series ◽  
Invasive Disease ◽  
Fungal Species ◽  
Fungal Sinusitis ◽  
Pertinent Literature ◽  
Invasive Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Treatment Plans ◽  
Fungal Stain

Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species ( Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

Allergic fungal rhinosinusitis with skull base and orbital erosion

2009 ◽  
Vol 124 (2) ◽  
pp. 161-165 ◽  
Author(s):  
M S Marfani ◽  
M A Jawaid ◽  
S M Shaikh ◽  
K Thaheem
Keyword(s):  
Skull Base ◽  
Sinus Surgery ◽  
Common Finding ◽  
Nasal Discharge ◽  
Topical Steroids ◽  
Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Postnasal Drip ◽  
Imaging Results

AbstractIntroduction:Allergic fungal rhinosinusitis is a benign, noninvasive sinus disease related to hypersensitivity to fungal infection having bony skull base and orbital erosion as common finding.Patients and method:This descriptive study was conducted at the department of otorhinolaryngology, Dow University of Health Sciences, Karachi, Pakistan, from April 2003 to March 2006. In forty-seven proven cases of allergic fungal sinusitis the following information was recorded: demographic data, signs and symptoms, laboratory investigation results, imaging results, pre- and post-operative medical treatment, surgery performed, follow up, and residual or recurrent disease. The Statistical Package for the Social Sciences version 10.0 software was used for data analysis.Results:Findings indicated that allergic fungal rhinosinusitis usually occurred in the second decade of life (51.06 per cent) in males (70.21 per cent), allergic rhinitis (100 per cent) and nasal polyposis (100 per cent). Nasal obstruction (100 per cent), nasal discharge (89.36 per cent), postnasal drip (89.36 per cent), and unilateral nasal and paranasal sinus involvement (59.57 per cent) were significant features. Aspergillus (59.57 per cent) was the most common aetiological agent. Combined orbital and skull base erosion was seen in 30.04 per cent of cases, with male preponderance 6.8:1. Endoscopic sinus surgery was performed in all cases, and recurrent or residual disease was observed in 19.14 per cent.Conclusion:Allergic fungal rhinosinusitis is a disease of young, immunocompetent individual. Skull base and orbital erosion are seen in one-third of cases. Bone erosion is 6.8 times more common in males than females. Orbital erosion is 1.5 times more common than skull base erosion. Endoscopic surgical debridement and drainage combined with topical steroids leads to resolution of disease in the majority of cases, without resorting to systemic antifungal agents, craniotomy or dural resection.

Paranasal Sinuses Fungal Balls in Children

2010 ◽  
Vol 3 (3) ◽  
pp. 181-183
Author(s):  
Sunita Agarwal
Keyword(s):  
Case Report ◽  
Young Children ◽  
Ct Scan ◽  
Paranasal Sinuses ◽  
Histopathological Examination ◽  
Fungal Sinusitis ◽  
Provisional Diagnosis ◽  
Invasive Fungal Sinusitis ◽  
First Case ◽  
Rule Out

Abstract Objective Rare cases of fungal balls of paranasal sinuses in children. No case has been reported in young children so far. However, allergic aspergillosis has been reported in young children. Method A case report of 2 cases of fungal balls of paranasal sinuses in children and review of the current literature concerning fungal balls of paranasal sinuses in children are presented. Result 2 cases of fungal balls in paranasal sinuses were diagnosed in children of 9 and 10 years respectively. Both of them presented with nasal obstruction and eye signs provisional diagnosis was based on CT scan findings. FESS was done and fungal balls were subjected to histopathological examination to rule out invasive fungal sinusitis, fungal staining and culture were done which confirmed the diagnosis of Aspergillosis. Conclusion To our knowledge this is the first case report of fungal balls in PNS in children in otolaryngology literature. Both the patients were males with age of 9 and 10 years respectively.

scholarly journals FREQUENCY OF BONE EROSION ON COMPUTERIZED TOMOGRAPGHY SCAN IN ALLERGIC FUNGAL RHINOSINUSITIS

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S428-31
Author(s):  
Muhammad Ali ◽  
Saima Attiq ◽  
Sayed Nusrat Raza ◽  
Abdul Hakim ◽  
Shakeel Ahmed ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Paranasal Sinuses ◽  
Bone Erosion ◽  
Severe Disease ◽  
Ethmoid Sinus ◽  
Military Hospital ◽  
Bone Erosions ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Tomography Scan

Objective: To analyze the frequency and sites of bone erosion on computerized tomograghy scan in Allergic Fungal Rhinosinustis in Pakistan. Study Design: Retrospective observational study. Place and Duration of Study: Department of ENT, Combined Military Hospital Lahore, Malir Karachi and Rawalpindi, from Jan 2010 to Dec 2019. Methodology: Total 230 cases of Allergic Fungal Rhinosinusitis were screened, out of which 85 patients having bone erosions on computerized tomograpghy scan were included in the study. Bone erosion in different paranasal sinuses and their sub sites were evaluated. Depending upon the number of bone erosion, patients were divided into three categories as mild, moderate and severe. Those having erosion at a single site were labelled as mild, those with two sub sites of erosion as moderate and those with more than two subsites of erosion were labelled as severe cases. Results: Detailed evaluation of computerized tomography scan of paranasal sinuses revealed bone erosion in 85/230 (36.9%) cases. Mean affected age was 23.96 ± 12.71 years. There were 52 (61.1%) males and 33 (38.9%) females. Ethmoid sinus was the most commonly involved sinus to have bone erosions 55 (38.19%) followed by maxillary sinus 38 (26.38%) then sphenoid sinus 27 (18.75%) and lastly frontal sinus 24 (16.6%). Out of 85 patients 48 (56.1%) were having mild, 22 (25.8%) moderate and 15 (17.6%) had severe disease. Conclusion: Allergic Fungal Rhinosinusitis has high frequency of bone erosion. Computerized tomography scan is an important and effective investigation in finding these bony erosions and ethmoid sinus is the.....

scholarly journals Fungal sinusitis clinical presentation, latest management: A Review Update

2015 ◽  
Vol 12 (1) ◽  
pp. 16-19
Author(s):  
Bithi Bhowmik
Keyword(s):  
Paranasal Sinuses ◽  
Disease Process ◽  
High Rate ◽  
Fungus Ball ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Invasive Fungal Sinusitis ◽  
Radiologic Imaging ◽  
Chronic Invasive

Fungal sinusitis is a relatively common, often misdiagnosed disease process involving the paranasal sinuses. It is a serious condition, as certain forms of fungal sinusitis are associated with a high rate of mortality. Successful treatment requires a prompt diagnosis and frequently relies on radiologic imaging, specifically computed tomography (CT) and magnetic resonance (MR) imaging. The classification of fungal sinusitis is ever changing, but under the most current and widely accepted classification fungal sinusitis is broadly categorized as either invasive or noninvasive. Invasive fungal sinusitis is defined by the presence of fungal hyphae within the mucosa, submucosa, bone, or blood vessels of the paranasal sinuses. Invasive fungal sinusitis is subdivided into acute invasive fungal sinusitis, chronic invasive fungal sinusitis, and chronic granulomatous invasive fungal sinusitis. Conversely, noninvasive fungal sinusitis is defined by the absence of hyphae within the mucosal and other tissues of the paranasal sinuses. Noninvasive fungal sinusitis is subdivided into allergic fungal sinusitis and fungus ball (fungal mycetoma).Journal of Science Foundation, 2014;12(1):16-19

scholarly journals Recurrence Pattern and Complication Rate of Allergic Fungal Sinusitis: A 10-Year Tertiary Center Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yazeed Alghonaim ◽  
Abdulrhman Alfayez ◽  
Riyadh Alhedaithy ◽  
Abdullah Alsheikh ◽  
Malak Almalki
Keyword(s):  
Chronic Rhinosinusitis ◽  
Recurrence Rate ◽  
Nasal Obstruction ◽  
Recurrent Disease ◽  
Disease Recurrence ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Bilateral Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

Background. Allergic fungal rhinosinusitis is a noninvasive form of highly recurrent chronic rhinosinusitis. Despite the advancement in medical and surgical strategies, recurrence in AFRS in general poses another challenging problem with reported incidence that eventually can reach more than 60%. Recognition and understanding the pattern of disease recurrence will lead to greater understanding of the disease response in our population. Method. A retrospective cohort study was performed in King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with chronic rhinosinusitis and underwent functional endoscopic sinus surgery from the period of January 2006 to December 2016 were reviewed. Results. 28 patients were found to have AFRS based on clinical, radiological, and microscopic examination suggestive of allergic fungal rhinosinusitis. Among these patients, 53% of them were female and 46% were male. The age ranged from 13 to 55 years, with a mean age of 31.57 years. 28.57% of the patients presented with recurrent allergic fungal sinusitis. The duration between the surgery and symptoms recurrence was around one year. Male and female patients had similar recurrence rate (50%). At first visit, 95% of the patients with nonrecurrent disease presented with nasal obstruction compared to 87.5% of the patients with recurrent disease. On the other hand, patients with recurrent disease had more nasal discharge (87.5%), postnasal drip (37.5%), facial pressure/pain (50%), headache (50%), nasal polyposis (87.5%), hypertrophy of inferior turbinate (37.5%), and proptosis (12.5%). Nasal obstruction (87.5%) and nasal polyps (87.5%) were the most common presenting symptoms for the disease recurrence. The pattern of disease recurrence in the previously unilateral disease was 18% ipsilateral and 27% bilateral. For the patients who had bilateral disease formerly, 17% (n = 3) of them had recurrent bilateral disease. Conclusion. Allergic fungal rhinosinusitis is a distinct clinical entity. A high recurrence rate is a pathognomonic feature of the disease, despite all the development in medical and surgical trials. This study demonstrated that recurrence rate is lower in our population. However, more studies with a greater number of patients are needed in the future to clearly recognize the pattern of recurrence in patients with AFRS.

scholarly journals Aggressive Combination Treatment for Invasive Fungal Sinusitis in Immunocompromised Patients

2000 ◽  
Vol 79 (4) ◽  
pp. 278-285 ◽  
Author(s):  
Samieh S. Rizk ◽  
Dennis H. Kraus ◽  
Goetz Gerresheim ◽  
Satvinder Mudan
Keyword(s):  
Hematologic Malignancies ◽  
Fungal Disease ◽  
Fungal Sinusitis ◽  
Granulocyte Colony Stimulating Factor ◽  
Term Survival ◽  
Invasive Fungal Sinusitis ◽  
Aggressive Management ◽  
Underlying Malignancy ◽  
Stimulating Factor

Invasive sinonasal fungal disease is a potentially fatal complication of chemotherapy-induced immunosuppression and neutropenia. We reviewed the outcomes of seven cancer patients who had been diagnosed with invasive fungal sinusitis; six patients had hematologic malignancies and one had breast cancer. At the time of their sinus diagnosis, all patients had been hospitalized and were receiving combination chemotherapy for their underlying malignancy. Impairment of their immune function was characterized by an absolute neutrophil count of less than 1,000/mm3. Aggressive management of their sinonasal fungal disease consisted of surgical debridement and systemic amphotericin B for all patients, and treatment with granulocyte colony-stimulating factor for two patients. Invasive Aspergillus infection was identified in six patients and invasive Candida albicans infection in one. Although the prognosis for these patients was poor and two patients died of the fungal infection, the aggressive treatment strategy resulted in long-term survival for the remaining five patients.

Allergic fungal rhinosinusitis—more than a fungal disease?

2013 ◽  
Vol 132 (2) ◽  
pp. 487-489.e1 ◽  
Author(s):  
Tineke Dutre ◽  
Surayie Al Dousary ◽  
Nan Zhang ◽  
Claus Bachert
Keyword(s):  
Fungal Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis
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