Management of Invasive Fungal Sinusitis

Soman, Rajeev; Sunavala, Ayesha

doi:10.1007/978-81-322-1530-1_8

Cited by 2 publications

(4 citation statements)

References 18 publications

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Section: Treatmentmentioning

confidence: 99%

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Fungal Rhinosinusitis: Unravelling the Disease Spectrum

Singh

2019

J. Maxillofac. Oral Surg.

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Fungal rhinosinusitis (FRS), once considered a rare disease, has seen a steep rise in incidence in recent times. This global rise in the burden of fungal disease is a consequence of an increment in the population with weakened immune systems. Increased life expectancy with rise in conditions like diabetes mellitus, medical advancements with invasive interventions, use of immunosuppressive drugs and chemo-radiotherapy all lead to unique risk situations. The situation becomes more alarming with the fact that there has been a significant rise in cases in immune-competent hosts with no predisposing factors. FRS represents a wide spectrum of disease ranging from the mild form of superficial colonization, allergic manifestations to life threatening extensive invasive disease. The categorization of disease into acute and chronic and invasive or noninvasive is important factor with implications in disease management and prognosis and this has been emphasized greatly in recent years. Diagnosis of FRS has been a challenge as the presenting clinical signs and symptoms and radiographic manifestations are often nonspecific. Definitive diagnosis requires direct fungi identification and hence culture and microscopic examination remain the gold standard. Availability of advanced and rapid diagnostic techniques is rare in majority of developing nations. Therapeutic dilemmas are another aspect of the management of FRS as in spite of the availability of new antifungal drugs, treatment is often empirical due to non-availability of early diagnosis, rapid disease progression and high costs of antifungal drugs. A description of the different types of FRS, their diagnosis and management has been presented in this review.

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Section: Treatmentmentioning

confidence: 99%

“…Extension into the cranium can be fatal. [22,37] While some authors opine that this form has no specific geographic predilection others state that it is uncommon in the United states and is reported more from India and the Middle east [57,58].…”

Section: Reversal Of Risk Factorsmentioning

confidence: 99%

Fungal Rhinosinusitis: Unravelling the Disease Spectrum

Singh

2019

J. Maxillofac. Oral Surg.

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“…Prompt and aggressive surgical debridement, appropriate antifungal therapy along with simultaneous elimination of underlying causes of immunosuppression and risk factors are the mainstays of AIFRS management [18,19] . Timely but difficult surgical decisions with disfiguring outcomes like maxillectomy and orbital exenteration can be lifesaving.…”

Section: Managementmentioning

confidence: 99%

“…Extension into the cranium can be fatal. [8,21] While some authors opine that this form has no specific geographic predilection others state that it is uncommon in the United States and is reported more from India and the Middle east [19,22] . The most commonly reported fungal pathogen is Aspergillus fumigatus [23,24] .…”

Section: B Chronic Invasive Fungal Rhinosinusitis (Cifrs) [Non-granul...mentioning

confidence: 99%

Fungal Rhinosinusitis

Saini¹,

Singh²,

Saroj³

et al. 2022

NMO Journal

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Fungal rhinosinusitis (FRS) once considered a rare disease. This global rise in the burden of fungal disease is a consequence of an increment in the population with weakened immune systems. Increased life expectancy with rise in conditions like diabetes mellitus, medical advancements with invasive interventions, use of steroid, wider uses of broad-spectrum antibiotics, immunosuppressive treatments for transplantation and autoimmune diseases, increased incidence of immune deficiency disease. Fungal infections of the paranasal sinuses are in fact a spectrum of diseases rather than one distinct entity. As such, there has been much published on the classification of fungal rhinosinusitis (FRS).Early classifications of FRS used the causative organism as the descriptor, i.e., aspergillosis, mucormycosis, etc. Rapid diagnosis and prompt treatment may save at least some of these patients. When fever with neutropenia and sinonasal symptoms are seen in patients with impaired immune function maintaining a high index of suspicion is essential, and the appropriate diagnostic work up should involve imaging studies and nasal endoscopy with a possible biopsy so as to initiate treatment in a timely manner.Clinical and histopathologic features of fungal rhinosinusitis are specific to each form, and criteria for diagnosis have been developed. This review of fungal sinus diseases summarizes invasive and noninvasive fungal rhinosinusitis forms but concentrates on AFS because of its high prevalence and the fundamental role the allergist-immunologist plays in its diagnosis and treatment.

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Management of Invasive Fungal Sinusitis

Cited by 2 publications

References 18 publications

Fungal Rhinosinusitis: Unravelling the Disease Spectrum

Fungal Rhinosinusitis: Unravelling the Disease Spectrum

Fungal Rhinosinusitis

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