Invasive Fungal Sinusitis of the Sphenoid Sinus

Lee, Dong Hoon; Yoon, Tae Mi; Lee, Joon Kyoo; Joο, Young Eun; Park, Kyung Hwa; Lim, Sang Chul

doi:10.3342/ceo.2014.7.3.181

Cited by 52 publications

(54 citation statements)

References 24 publications

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“…Invasive fungal disease is rare and appears mainly in patients with impaired immune function. But there are also case reports describing invasive fungal disease, such as invasive sinusitis or rhinosinusitis (30, 31) or craniocerebral aspergillosis of sinonasal origin, in immunocompetent patients (32). These data tell us that the powerful immune defense system of humans has in fact evolved effective mechanisms to avoid ubiquitous fungi to be pathogenic in most immune-competent subjects, but the arms race between fungi and the immune system of vertebrates is still visible.…”

Section: Fungi In An Evolutionary Perspectivementioning

confidence: 99%

An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS

Daschner

2017

Front. Immunol.

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Among potential environmental harmful factors, fungi deserve special consideration. Their intrinsic ability to actively germinate or infect host tissues might determine a prominent trigger in host defense mechanisms. With the appearance of fungi in evolutionary history, other organisms had to evolve strategies to recognize and cope with them. Existing controversies around dampness and mold hypersensitivity syndrome (DMHS) can be due to the great variability of clinical symptoms but also of possible eliciting factors associated with mold and dampness. An hypothesis is presented, where an evolutionary analysis of the different response patterns seen in DMHS is able to explain the existing variability of disease patterns. Classical interpretation of immune responses and symptoms are addressed within the field of pathophysiology. The presented evolutionary analysis seeks for the ultimate causes of the vast array of symptoms in DMHS. Symptoms can be interpreted as induced by direct (toxic) actions of spores, mycotoxins, or other fungal metabolites, or on the other side by the host-initiated response, which aims to counterbalance and fight off potentially deleterious effects or fungal infection. Further, individual susceptibility of immune reactions can confer an exaggerated response, and magnified symptoms are then explained in terms of immunopathology. IgE-mediated allergy fits well in this scenario, where individuals with an atopic predisposition suffer from an exaggerated response to mold exposure, but studies addressing why such responses have evolved and if they could be advantageous are scarce. Human history is plenty of plagues and diseases connected with mold exposure, which could explain vulnerability to mold allergy. Likewise, multiorgan symptoms in DMHS are analyzed for its possible adaptive role not only in the defense of an active infection, but also as evolved mechanisms for avoidance of potentially harmful environments in an evolutionary past or present setting.

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Section: Fungi In An Evolutionary Perspectivementioning

confidence: 99%

An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS

Daschner

2017

Front. Immunol.

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“…Amphotericin B and voriconazole are both commonly prescribed for the treatment of invasive fungal disease 32. Intraoperative findings may not be distinguished from fungal ball; however, intraoperative mucosal necrosis may be observed as a clue for invasive nature 31. The presence of fungus ball suggests the potential of a previous fungal ball transformation into invasive fungal sphenoiditis 31.…”

Section: Diseases Of Chronic Sphenoid Rhinosinusitismentioning

confidence: 99%

“…Intraoperative findings may not be distinguished from fungal ball; however, intraoperative mucosal necrosis may be observed as a clue for invasive nature 31. The presence of fungus ball suggests the potential of a previous fungal ball transformation into invasive fungal sphenoiditis 31. The prognosis of chronic invasive fungal rhinosinusitis is rather poor with a report of 25% mortality rate 31…”

Section: Diseases Of Chronic Sphenoid Rhinosinusitismentioning

confidence: 99%

Chronic sphenoid rhinosinusitis: management challenge

Charakorn¹,

Snidvongs²

2016

JAA

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Chronic sphenoid rhinosinusitis is a spectrum of inflammatory diseases in isolated sphenoid sinus which may persist over a period of 12 weeks. It is a different entity from other types of rhinosinusitis because clinical presentations include headache, visual loss or diplopia, and patients may or may not have nasal obstruction or nasal discharge. Nasal endoscopic examination is useful, and computed tomography is mandatory. The disease requires comprehensive knowledge and appropriate imaging technique for diagnosis. To treat patients with chronic sphenoid rhinosinusitis, surgical treatment with endoscopic transnasal sphenoidotomy is often required. As there are no recent updated reviews of chronic sphenoid rhinosinusitis, in this article, we review the anatomy of the sphenoid sinus and its clinical relationship with the clinical signs and symptoms of the disease, the imaging findings of each diagnosis and the comprehensive surgical techniques.

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“…Second, the combination of MRI and surgical biopsy was useful for the correct diagnosis of her condition. MRI is more sensitive than CT for identifying the involvement of extrasinus lesions in IFS . Surgical biopsy and histopathological examinations are also important because cultures of specimens obtained from patients with mucormycosis are usually negative, even when the specimen is taken from the site of infection .…”

Section: Discussionmentioning

confidence: 99%

Retrobulbar optic neuropathy associated with sphenoid sinus mucormycosis

Sano

Kobayashi

Takaoka

et al. 2018

Neurology & Clinical Neurosc

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Because fungi usually spread from the paranasal sinuses to the orbital apex in invasive fungal sinusitis (IFS), IFS often presents as an orbital apex syndrome (OAS) characterized by dysfunction of cranial nerves II, III, IV, V1, and VI. We report a case of sphenoid sinus mucormycosis that presented as isolated retrobulbar optic neuropathy. A 94‐year‐old woman presented with acute blindness in the right eye. Examination revealed the absence of light perception and pupillary reflex in the right eye. Head MRI showed a mass in the right sphenoid sinus, which was contiguous with the right optic nerve. She underwent endoscopic surgery, and a histopathological diagnosis of mucormycosis was established. Treatment with intravenous liposomal amphotericin B reduced the size of the mass. She has survived for more than 1 year without recurrence. Clinicians should consider that IFS can present as isolated retrobulbar optic neuropathy.

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Invasive Fungal Sinusitis of the Sphenoid Sinus

Cited by 52 publications

References 24 publications

An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS

An Evolutionary-Based Framework for Analyzing Mold and Dampness-Associated Symptoms in DMHS

Chronic sphenoid rhinosinusitis: management challenge

Retrobulbar optic neuropathy associated with sphenoid sinus mucormycosis

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