Invasive Fungal Sinusitis


Authors: P. Čelakovský 1;  J. Vokurka 1;  J. Laco 2;  I. Hybášek 1
Authors place of work: LF UK a FN Hradec Králové Ušní, nosní a krční klinika 1;  LF UK a FN Hradec Králové Fingerlandův ústav patologie 2
Published in the journal: Cesk Slov Neurol N 2011; 74/107(2): 163-167
Category: Přehledný referát

Summary

The invasive form of fungal sinusitis is a rare disease, but it occurs commonly in immunodeficient patients. The fungi most often responsible for these infections are zygomycetes (Absidia, Mucor, and Rhizopus spp.) and Aspergillus spp. The disease is characterized by tissue destruction and rapid spread via vascular and perineural invasion. Typically affected structures are the orbit and central nervous system. The initial signs are often non-specific. The clinician must maintain a high index of suspicion when an immunocompromised patient experiences fever of unknown origin, not responding to antibiotic therapy. The later symptoms are dependent on the type and extent of destruction of the surrounding structures. The rapid spread to the orbit, soft tissue of the face and to the intracranial space, with a high mortality rate, make a prompt and appropriate diagnosis of this infection crucial. Imaging methods demonstrate the invasive process at the skull base and its extension, while histology is critical for determining the invasive form of fungal infection. The recommended treatment is aggressive surgical removal of the fungal material in combination with intravenous antifungal therapy. Especially in recent years, the disease has become worthy of far closer attention because of the increasing number of surviving haemato-oncological patients.

Key words:
invasive fungal sinusitis – intracranial and orbital complications


Zdroje

1. Michael RC, Michael JS, Ashbee SH, Mathews MS. Mycological profile of fungal sinusitis: An audit of specimens over a 7-year period in a tertiary care hospital in Tamil Nadu. Indian J Patol Mikrobiol 2008; 51(4): 493–496.

2. Thrasher RD, Kingdom TT. Fungal infection of the head and neck: an update. Otolaryngol Clin North Am 2003; 36(4): 577–594.

3. DeShazo RD, Chapin K, Swain RE. Fungal sinusitis. N Engl J Med 1997; 337(4): 254–259.

4. Taj-Aldeen SJ, Chiny-Lopez A. Allergic Aspergillus flavus rhinosinusitis: a case report from Quatar. Eur Arch Otorhinolaryngol 2003; 260(6): 331–335.

5. Knipping S, Holzhausen HJ, Koesling S, Bloching M. Invasive aspergillosis of the paranasal sinuses and the skull base. Eur Arch Otorhinolaryngol 2007; 264(10): 1163–1169.

6. Hachem RY, Boktour MR, Hanna AH, Husni R, Hanna EY, Keutgen X et al. Sinus surgery combined with antifungal therapy is effective in the treatment of invasive aspergillus sinusitis in neutropenic patiens with cancer. Infection 2008; 36(6): 539–542.

7. Hosseini SM, Borghei P. Rhinocerebral mucormycosis: pathways of spread. Eur Arch Otorhinolaryngol 2005; 262(11): 932–938.

8. Pinzer T, Reiss M., Bourquain H, Krishnan KG, Schackert G. Primary aspergillosis of the sphenoid sinus with pituitary invasion – a rare differential diagnosis of sellar lesions. Acta Neurochir 2006; 148(10): 1085–1090.

9. Dunn JJ, Wolfe MJ, Trachtenberg J, Kriesel JD, Orlandi RR, Carrol KC. Invasive fungal sinusitis caused by Scytalidium dimidiatum in a lung transplant recipient. J Clin Microbiol 2003; 41(12): 5817–5819.

10. Sedláček P. Terapie invazivních mykotických infekcí u imunosuprimovaných pacientů. Onkologie 2008; 2(3): 186–190.

11. Chan LL, Singh S, Jones D, Diaz EM jr, Ginsberg LE. Imaging of mucormycosis skull base osteomyelitis. Am J Neuroradiol 2000; 21(5): 828–831.

12. Kennedy CA, Adams GL, Neglia JP, Giebink GS. Impact of surgical treatment on paranasal fungal infection in bone marrow transplant patiens. Otolaryngol Head Neck Surg 1997; 116(6): 610–616.

13. Xi L, Fukushima K, Lu Ch, Takizawa K, Liao R, Nishimura K. First case of Arthrographis kalrae ethmoid sinusitid and ophthalmitis in the People´s Republic of China. J Clin Microbiol 2004; 42(10): 4828–4831.

14. Chin-Hong PV, Sutton DA, Roemer M, Jacobson MA, Aberg JA. Invasive fungal sinusitis and meningitis due to Arthrographis Kalrae in a patient with AIDS. J Clin Microbiol 2001; 39(2): 804–807.

15. Lin JJ, Wu CHT, Hsia SH, Wang HS, Lin KL. Pneumocephalus: A rare presentation of Candida sphenoid sinusitis. Pediatr Neurol 2009; 40(5): 398–400.

16. Hurst RW, Judkins A, Boler W, Chu A, Loevner LA. Mycotic aneurysma and cerebral infarction resulting from fungal sinusitis: Imaging and pathologic correlation. Am J Neuroradiol 2001; 22(5): 858–863.

17. McLean FM, Ginsberg LE, Stanton CA. Perineural spread of rhinocerebral mucormycosis. AJNR Am J Neuroradiol 1996; 17(1): 114–116.

18. DelGaudio JM, Swain RE jr, Kingdom TT, Miller S, Hudgins PA. Computed tomographic findings in patiens with invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 2003; 129(2): 236–240.

19. Bazan C, Rinaldi MG, Rauch RR, Jinkins JR. Fungal infections of the brain. Neuroimaging Clin N Am 1991; 1: 57–88.

20. Rhodes J, Bode R, McCuan-Kirsch C. Elastase production in clinical isolates of Aspergillus. Diagn Microbiol Infect Dis 1988; 10(3): 165–170.

21. Schwarz S, Thiel S. Clinical presentation of invasive aspergillosis. Mycoses 1997; 40 (Suppl 2): 21–24.

22. Berger SA, Edberg SC, Davis G. Infectious disease in the sella turcica. Rev Infect Dis 1986; 8(5): 747–755.

23. Tzen KY, Yen TC, Lin KJ. Value of Ga-67 SPECT in monitoring the effects of therapy in invasive aspergillosis of the sphenoid sinus. Clin Nucl Med 1999; 24(12): 938–941.

24. deShazo RD, O’Brien M, Chapin K, Soto-Aguilar M, Gardner L, Swain R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 1997; 123(11): 1181–1188.

25. Reddy CE, Gupta AK, Singh P, Mann SB. Imaging of granulomatous and chronic invasive fungal sinusitis: Comparison with allergic fungal sinusitis. Otolaryngol Head Neck Surg 2010; 143(2): 294–300.

26. deShazo RD. Syndromes of invasive fungal sinusitis. Med Mycol 2009; 47 (Suppl 1): S309–S314.

27. Rizk SS, Kraus DH, Gerresheim G, Mudan S. Aggressive combination treatment for invasive fungal sinusitis in immunocompromised patiens. Ear Nose Throat J 2000; 79(4): 278–284.

28. Kurita H, Shiokawa Y, Furuya K, Segawa H, Sano K. Parasellar aspergillus granuloma extending from the sphenoid sinus: report of two cases. Surg Neurol 1995; 44(5): 489–494.

29. Swift AC, Denning DW. Skull base osteitis following fungal sinusitis. J Laryngol Otol 1998; 112(1): 92–97.

30. Elgamal E, Murshid W. Intracavitary administration of amphotericin B in the treatment of cerebral aspergillosis in a non immune-compromised patient: case report and review of the literature. Br J Neurosurg 2000; 14(2): 137–141.

Štítky
Dětská neurologie Neurochirurgie Neurologie

Článek vyšel v časopise

Česká a slovenská neurologie a neurochirurgie

Číslo 2

2011 Číslo 2

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se