Invasive aspergillosis of the paranasal sinuses and the skull base

Knipping, S.; Holzhausen, H.-J.; Koesling, Sabrina; Bloching, M.

doi:10.1007/s00405-007-0336-7

Cited by 24 publications

(20 citation statements)

References 21 publications

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“…Reportedly, patients with HIES and a defective Th17 response are at risk for invasive fungal infections (19,23). An impaired mucosal host defense, as demonstrated by defective IL-22 or IL-17A production, may have led to increased fungal colonization of the nasal cavity and paranasal sinuses, impaired epithelial integrity, and invasion of the deeper tissues (24,25).…”

Section: Discussionmentioning

confidence: 99%

Cytokine Production Assays Reveal Discriminatory Immune Defects in Adults with Recurrent Infections and Noninfectious Inflammation

Oever¹,

Veerdonk²,

Joosten³

et al. 2014

Clin. Vaccine Immunol.

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Cytokine production assays have been primarily used in research settings studying novel immunodeficiencies. We sought to determine the diagnostic value of cytokine production assays in patients with recurrent and/or severe infectious diseases (IDs) without known immunodeficiencies and unclassified noninfectious inflammatory disorders (NIIDs). We retrospectively examined cytokine production in whole-blood and peripheral blood mononuclear cell samples from 157 adult patients. A cytokine production rate of <5% of that of healthy controls was considered defective. While monocyte-derived cytokine (tumor necrosis factor alpha [TNF-α], interleukin-1β [IL-1β], and IL-6) production was rarely affected, 30% of all included patients had deficient production of interferon gamma (IFN-γ), IL-17A, or IL-22. Twenty-five percent of the NIID patients displayed defective IFN-γ production, whereas IL-17A production was generally unaffected. In the group of ID patients, defective IFN-γ production was found in 19% and 14% of the patients with viral and bacterial infections, respectively, and in 38%, 24%, and 50% of patients with mycobacterial, mucocutaneous, and invasive fungal infections, respectively. Defective IL-17A and IL-22 production was mainly confined to ID patients with mucocutaneous fungal infections. In conclusion, cytokine production assays frequently detect defective Th1 responses in patients with mycobacterial or fungal infections, in contrast to patients with respiratory tract infections or isolated bacterial infections. Defective IL-17A and IL-22 production was primarily found in patients with fungal infections, while monocyte-derived cytokine production was unaffected. Thus, lymphocyte-derived cytokine production assays are helpful in the diagnostic workup of patients with recurrent infections and suspected immunodeficiencies and have the potential to reveal immune defects that might guide adjunctive immunomodulatory therapy.

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Section: Discussionmentioning

confidence: 99%

Cytokine Production Assays Reveal Discriminatory Immune Defects in Adults with Recurrent Infections and Noninfectious Inflammation

Oever¹,

Veerdonk²,

Joosten³

et al. 2014

Clin. Vaccine Immunol.

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“…The patients present with symptoms like proptosis, facial swelling, ophthalmoplegia, loss of vision, and hypoaesthesia of the ophthalmic and maxillary nerve. Computed tomography and MRI usually show extensive sino-orbital and skull base lesions [3]. Only small series of patients with this infection have been described; the radiographic diagnosis of cerebral and craniofacial aspergillosis has varied and has been relatively nonspecific.…”

Section: Discussionmentioning

confidence: 99%

“…Invasive cranio-orbital aspergillosis originating in the sphenoid sinus is rare and mostly occurs in immunocompromised patients with poor outcomes [2]. Invasive aspergillosis originating from the paranasal sinuses can cause an intra-cranial growth mainly along the skull base and larger vessels [3]. Orbital invasion readily occurs due to breach of thin bony partition of lamina papyracea leading to proptosis and gradual loss of vision.…”

Section: Introductionmentioning

confidence: 99%

Invasive Rhino-Orbital Aspergillosis

Arora

Nagarkar²,

Dass³

et al. 2011

Indian J Otolaryngol Head Neck Surg

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Invasive aspergillosis usually affects immune-compromised patients and is common in diabetics. Proptosis, visual loss and ophthalmoplegia due to intra-orbital extension are common presentations. Three out of five patients in our series were immune-compromised. All the patients had visual loss and three patients presented with unilateral blindness. Three patients were treated by surgical debridement followed by Amphotericin B therapy. Two patients who had intra-cranial extension of the disease died during the treatment. Only one patient had improvement in vision following the treatment. High index of suspicion in immune-compromised patients, early diagnosis and prompt aggressive treatment is required to achieve clinical cure.

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“…Few studies have reported the effect of IA on the central portion of the face in immunocompetent individuals 1,2,4,5,11 . Thus far, no study has reported its occurrence in relation to cocaine abuse.…”

Section: Case Reportmentioning

confidence: 99%

“…The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion 2,3 . Patients with an impaired immune system or with disrupted anatomical and physiological barriers are at a high risk of developing the invasive form of the disease, characterized by fungal hyphae in tissues, which is associated with high mortality rates 4 .…”

Section: Introductionmentioning

confidence: 99%