Purpose of review: Acute invasive fungal rhinosinusitis (AIFR) is an aggressive and often fatal infection with wide variability of both presentation and survival rate across several published case reports and small case series. This review discusses treatment outcomes for this challenging disease.
Recent findings: For several decades, the use of medical therapy (consisting primarily of intravenous antifungals) combined with surgical resection and/or debridement has been widely recommended for the treatment of AIFR. Unfortunately, because of the rarity of AIFR, few large-scale studies have evaluated 'best options' for disease management. Most recent studies show few changes in either survival outcomes or management over time.
Summary: Although overall survival rates remain below about 60%, outcomes are significantly more favorable for those patients undergoing surgical/endoscopic resection and who have reversible predisposing factors that can be rapidly managed (e.g., diabetes). The indications for orbital exenteration remain unclear, but recent studies suggest that this procedure may not change outcome in most patients.