Pediatric invasive sinonasal Scopulariopsis brevicaulis--a case report and literature review

Int J Pediatr Otorhinolaryngol. 2011 Jul;75(7):891-3. doi: 10.1016/j.ijporl.2011.03.026. Epub 2011 May 4.

Abstract

Objective: Acute invasive fungal sinusitis (AIFS) appears mainly in immunocompromized patients and may be caused by various pathogens. We describe a teenager with invasive sinonasal Scopulariopsis brevicaulis and review all the reports on this rare pathogen.

Methods: A literature search on Scopulariopsis sinonasal invasive infections was performed and clinical data including age, gender, co-morbidities, treatment and prognosis was collected on all the patients.

Results: A 17 years old boy with acute myelocytic leukemia and Scopulariopsis brevicaulis sinonasal infection was successfully treated at our department with a combination of extensive surgical debridement and antifungal antibiotics. We found six articled describing six patients with AIFS due to Scopulariopsis species. Four patients were adults and two were children, 3 males and 3 females. Two had an infection with Scopulariopsis acremoium, one with Scopulariopsis candida and for 3 patients no data was given on the specific Scopulariopsis species. All the patients except one were immunocompromized. One patient was treated with antifungal drugs, 2 with surgery and 4 patients received antifungals and were operated. One patient died due to the fungal infection and two patients died due to other causes.

Conclusions: Scopulariopsis AIFS is a life threatening disease affecting mainly immunocompromized patients, both children and adults. No clear treatment regimen has been established yet. We describe the first case of a teenager with Scopulariopsis brevicaulis sinonasal infection treated successfully with a combination of wide local excision and antifungal therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Antifungal Agents / therapeutic use
  • Ascomycota*
  • Child
  • Female
  • Humans
  • Immunocompromised Host*
  • Leukemia, Myeloid, Acute / immunology
  • Male
  • Mycoses / diagnosis*
  • Mycoses / drug therapy
  • Mycoses / immunology
  • Rhinitis / diagnosis*
  • Rhinitis / drug therapy
  • Rhinitis / immunology
  • Rhinitis / microbiology
  • Sinusitis / diagnosis
  • Sinusitis / drug therapy
  • Sinusitis / immunology
  • Sinusitis / microbiology

Substances

  • Antifungal Agents