[Clinical analyses of the diagnosis and treatment of invasive fungal rhinosinusitis: report of 14 cases]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 Aug 7;51(8):561-7. doi: 10.3760/cma.j.issn.1673-0860.2016.08.001.
[Article in Chinese]

Abstract

Objective: Through the retrospective analysis of the clinical data in 14 cases of invasive fungal rhinosinusitis (IFRS), the clinical characteristics, diagnosis and treatment of this disease were evaluated.

Methods: Fourteen clinically confirmed cases of IFRS since January 2008 to October 2015 were evaluated.collected, the clinical features, diagnosis, treatment and prognosis were analyzed to obtain a more comprehensive understanding for clinical reference. Fourteen patients were confirmed by pathological examination as IFRS, including 9 cases of aspergillus, 4 cases of mucor, and 1 case of rhinocerebral zygomycosis; including 5 cases of acute IFRS, 9 cases of chronic IFRS. All patients were treated with endoscopic surgery and intravenous antifungal therapy.

Results: Nine cases of chronic IFRS (including 1 case of mucor, 7 cases of aspergillus and 1 case of rhinocerebral zygomycosis) were cured, but the vision loss, diplopia or blindness, hard palate perforation remained. Five cases of acute IFRS included 3 cases of mucor and 2 cases of aspergillus. Among the 3 cases of mucor, 2 cases were died and 1 case was cured. Among the 2 cases of aspergillus, 1 patient was cured and the other patient died of electrolyte disorder after discharge from hospital.

Conclusions: Patients with IFRS usually have diabetes. After the active surgical cleaning of lesion tissue and the systematic antifungal treatment with adequate dosage, these patients would have a better result. IFRS caused by mucor is ofen dangerous.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antifungal Agents / therapeutic use
  • Aspergillosis / diagnosis
  • Aspergillosis / therapy
  • Chronic Disease
  • Endoscopy
  • Humans
  • Mucormycosis / diagnosis
  • Mucormycosis / therapy
  • Prognosis
  • Retrospective Studies
  • Rhinitis / diagnosis*
  • Rhinitis / microbiology
  • Rhinitis / therapy*
  • Sinusitis / diagnosis*
  • Sinusitis / microbiology
  • Sinusitis / therapy*
  • Zygomycosis / diagnosis
  • Zygomycosis / therapy

Substances

  • Antifungal Agents