Invasive Fungal Sinusitis with Ophthalmological Complications: Case Series and Review of the Literature

Coutel, Maëlle; Duprez, Thierry; Huart, Caroline; Wacheul, Emilie; Boschi, Antonella

doi:10.1080/01658107.2020.1779315

Cited by 6 publications

(9 citation statements)

References 30 publications

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“…Cranial nerve symptoms (25% to 49%), 30,33,39,57 including facial anesthesia (8% to 55%), 5,7,15,31,37–38,56,58 palatal anesthesia (up to 8%), 15 and facial paralysis (25% to 44%), 33,47 as well as ophthalmologic symptoms/symptoms, which include loss of visual acuity (26% to 87%), 17,26,30,38 proptosis (16% to 100%), 35,45,47 ophthalmoplegia (17% to 60%), 28,38,42,58 diplopia/extraocular muscle weakness (9% to 50%), 7,24,46,55 and ptosis (up to 100% in some series) 26,35,45 frequently develop if the disease extends outside the sinonasal cavity.…”

Section: Signs and Symptomsmentioning

confidence: 99%

“…Cranial nerve symptoms (25% to 49%), 30,33,39,57 including facial anesthesia (8% to 55%), 5,7,15,31,[37][38]56,58 palatal anesthesia (up to 8%), 15 and facial paralysis (25% to 44%), 33,47 as well as ophthalmologic symptoms/symptoms, which include loss of visual acuity (26% to 87%), 17,26,30,38 proptosis (16% to 100%), 35,45,47 ophthalmoplegia (17% to 60%), 28,38,42,58 diplopia/extraocular muscle weakness (9% to 50%), 7,24,46,55 and ptosis (up to 100% in some series) 26,35,45 frequently develop if the disease extends outside the sinonasal cavity. 1) Overall survival 2) Immunostimulating therapy Symptoms included pain (65%), swelling (52%), congestion (43%), fever (42%), erythema (33%), necrosis (26%), numbness (18%), visual changes (18%), headache (18%), pupillary abnormalities (17%), drainage (17%), proptosis (13%), facial weakness (8%), and EOM weakness (7%).…”

Section: Physical Signs and Subjective Symptomsmentioning

confidence: 99%

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Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Roland

Humphreys

et al. 2023

Int Forum Allergy Rhinol

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BackgroundAcute invasive fungal sinusitis (AIFS) is an aggressive disease that requires prompt diagnosis and multidisciplinary treatment given its rapid progression. However, there is currently no consensus on diagnosis, prognosis, and management strategies for AIFS, with multiple modalities routinely employed. The purpose of this multi‐institutional and multidisciplinary evidence‐based review with recommendations (EBRR) is to thoroughly review the literature on AIFS, summarize the existing evidence, and provide recommendations on the management of AIFS.MethodsThe PubMed, EMBASE, and Cochrane databases were systematically reviewed from inception through January 2022. Studies evaluating management for orbital, non‐sinonasal head and neck, and intracranial manifestations of AIFS were included. An iterative review process was utilized in accordance with EBRR guidelines. Levels of evidence and recommendations on management principles for AIFS were generated.ResultsA review and evaluation of published literature was performed on 12 topics surrounding AIFS (signs and symptoms, laboratory and microbiology diagnostics, endoscopy, imaging, pathology, surgery, medical therapy, management of extrasinus extension, reversing immunosuppression, and outcomes and survival). The aggregate quality of evidence was varied across reviewed domains.ConclusionBased on the currently available evidence, judicious utilization of a combination of history and physical examination, laboratory and histopathologic techniques, and endoscopy provide the cornerstone for accurate diagnosis of AIFS. In addition, AIFS is optimally managed by a multidisciplinary team via a combination of surgery (including resection whenever possible), antifungal therapy, and correcting sources of immunosuppression. Higher quality (i.e., prospective) studies are needed to better define the roles of each modality and determine diagnosis and treatment algorithms.

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Section: Signs and Symptomsmentioning

confidence: 99%

Section: Physical Signs and Subjective Symptomsmentioning

confidence: 99%

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Roland

Humphreys

et al. 2023

Int Forum Allergy Rhinol

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“…Diagnosis is usually delayed, because of the absence of an apparent predisposing factor, a concealed symptomatology, as well as the lack of specific symptoms [8]. The prognosis of the invasive forms is poor due to its aggressiveness to invade the surrounding structures, particularly intracranial and orbital tissues, and in some cases dissemination to systemic organs [9].…”

Section: Discussionmentioning

confidence: 99%

“…Ct scan displays an excellent imaging tool. It commonly reveals sinus filling, mucosal thickening, and peri maxillary fat blurring due to a direct fungal tissue infiltration or vascular congestion [8]. Indeed, the evidence of bone destruction; which suggests a potentially invasive process; is a late finding and can be absent despite the extension of the lesion beyond the paranasal sinuses [11].…”

Section: Discussionmentioning

confidence: 99%

Invasive Chronic Fungal Sinusitis: Case Report

2023

J Otolaryngol Res & Rep

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Fungal rhinosinusitis is a rare entity, which can affect both healthy and immunocompromised individuals. It encompasses a wide spectrum of immune and pathological responses, including chronic, granulomatous, allergic and invasive forms. This last can extend to invasion of the orbit and the brain. We report the case of a young girl known to be asthmatic operated successfully in our department for an invasive fungal sinusitis.

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“…Ophthalmoplegia and blindness resulted from contiguous invasion of the optic nerve, 8 by true micropermeative defects through the sphenoid bone allowing early invasion of the orbital apex and cavernous sinus as highlighted by a recent review paper. 9 The phenomenon was assessed on DW images in three serial MR examinations (Fig. 5).…”

Section: Discussionmentioning

confidence: 99%

Intracranial brain parenchymal spread of mucormycosis through olfactory tract: a diffusion-weighted imaging-based concept

Sandron

Hantson

Duprez

2020

Acta Radiologica Open

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Mucormycosis is an opportunistic fungal infection involving among others the paranasal sinuses, nasal fossa and brain parenchyma. Mucor can invade the brain parenchyma by either contiguous spread from the paranasal sinuses or through vascular invasion. We report a case of fatal rhino-cerebral mucormycosis in whom cytotoxic edema at magnetic resonance diffusion-weighted imaging was symmetrically restricted to both neocortical and paleocortical primary areas of olfactory projection at earliest phase of the disease process. Shortly later tissue damage extended into the whole brain. This undescribed observation raised the hypothesis of preferential way of brain invasion by Mucor through the olfactory tract.

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Invasive Fungal Sinusitis with Ophthalmological Complications: Case Series and Review of the Literature

Cited by 6 publications

References 30 publications

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Diagnosis, Prognosticators, and Management of Acute Invasive Fungal Rhinosinusitis: Multidisciplinary Consensus Statement and Evidence‐Based Review with Recommendations

Invasive Chronic Fungal Sinusitis: Case Report

Intracranial brain parenchymal spread of mucormycosis through olfactory tract: a diffusion-weighted imaging-based concept

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