Factors associated with all-cause mortality in pediatric invasive fungal rhinosinusitis

Abstract

Introduction: Pediatric invasive fungal rhinosinusitis (PIFR) is a potentially lethal infection seen in immunocompromised pediatric patients. Even with timely treatments, mortality ranges between 18 and 80% of the cases.

Objective: To analyze the factors associated with all-cause mortality in pediatric patients with acute invasive fungal rhinosinusitis.

Setting: Tertiary pediatric referral center.

Results: A total of 18 patients were included, 12 male and 6 female. The average age at diagnosis was 8.7 years (range 4 months-17 years), with 56% overall mortality and 44% survival after 60 months. The most common cause of immunosuppression was acute lymphoblastic leukemia. The only factor found affecting mortality was a time between diagnosis and surgery greater than 7 days.

Conclusion: PIFR is an aggressive entity with high mortality. An appropriate diagnosis with an opportune surgical debridement followed by systemic antifungal therapy is essential to improve survival. Delay in surgical treatment is associated with higher mortality.

Keywords: Acute lymphoblastic leukemia; Death; Immunosuppression; Mortality; Pediatric invasive fungal rhinosinusitis.