Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center
Abstract Background Despite appropriate treatment, mortality of acute invasive fungal rhinosinusitis remains exceedingly high, surpassing 50%. Evidence on how to optimize its management is still limited. We present a case series from our institution aiming to fill the knowledge gap. Methods A retros...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2025-02-01
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| Series: | The Egyptian Journal of Otolaryngology |
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| Online Access: | https://doi.org/10.1186/s43163-024-00750-x |
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| author | Raúl Mellidez-Acosta Lidia Torres-García Miguel Saro-Buendía Natalia Jaramillo-Ángel Javier Cabrera-Guijo Catalina Bancalari-Díaz Noelia Muñoz-Fernández Lucas Fito-Martorell Miguel Armengot-Carceller Alfonso García-Piñero |
| author_facet | Raúl Mellidez-Acosta Lidia Torres-García Miguel Saro-Buendía Natalia Jaramillo-Ángel Javier Cabrera-Guijo Catalina Bancalari-Díaz Noelia Muñoz-Fernández Lucas Fito-Martorell Miguel Armengot-Carceller Alfonso García-Piñero |
| author_sort | Raúl Mellidez-Acosta |
| collection | DOAJ |
| description | Abstract Background Despite appropriate treatment, mortality of acute invasive fungal rhinosinusitis remains exceedingly high, surpassing 50%. Evidence on how to optimize its management is still limited. We present a case series from our institution aiming to fill the knowledge gap. Methods A retrospective descriptive study was conducted, selecting cases treated at our institution between January 2012 and January 2022. The following variables were analyzed: gender, age, underlying conditions, symptoms, histological study outcomes, microbiological study outcomes, administered antifungal treatment, surgical interventions, and survival following diagnosis. Results Seventeen patients were included in our study. The mean age was 55 years, with 12 males and 5 females. The most frequents underlying conditions were hematological malignancies (76.5%) and solid organ transplantation (11.8%). Surgical interventions were performed on 15 patients (88%), with 6 patients (35.3%) requiring a second intervention and 2 patients (11.8%) undergoing at least 3 interventions.3% patients succumbed to causes directly related to rhinosinusitis, with an average survival of 22 days, and 52.9% patients subsequently passed away due to complications related to their underlying condition, with an average survival of 171 days. Mid-term overall mortality was 88.2%, with an average survival of 111 days. Conclusion A shift in the patient profile was observed. Less fulminant courses have been evidenced, being oncohematotological disease and solid organ transplantation the main predisposing conditions, instead of poorly controlled diabetes. Even if direct mortality rates from AIFR are reduced (around 35%), the overall mortality rate of these patients is close to 90% with a median survival of less than 6 months. Then, an intense focus on the underlying disease and related complications is essential. |
| format | Article |
| id | doaj-art-f7772c4809074cc8a3ed4c100521ec06 |
| institution | Kabale University |
| issn | 2090-8539 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Otolaryngology |
| spelling | doaj-art-f7772c4809074cc8a3ed4c100521ec062025-02-09T12:09:04ZengSpringerOpenThe Egyptian Journal of Otolaryngology2090-85392025-02-014111810.1186/s43163-024-00750-xShift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary centerRaúl Mellidez-Acosta0Lidia Torres-García1Miguel Saro-Buendía2Natalia Jaramillo-Ángel3Javier Cabrera-Guijo4Catalina Bancalari-Díaz5Noelia Muñoz-Fernández6Lucas Fito-Martorell7Miguel Armengot-Carceller8Alfonso García-Piñero9Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeServicio de Otorrinolaringología, Hospital Universitari i Politècnic La FeAbstract Background Despite appropriate treatment, mortality of acute invasive fungal rhinosinusitis remains exceedingly high, surpassing 50%. Evidence on how to optimize its management is still limited. We present a case series from our institution aiming to fill the knowledge gap. Methods A retrospective descriptive study was conducted, selecting cases treated at our institution between January 2012 and January 2022. The following variables were analyzed: gender, age, underlying conditions, symptoms, histological study outcomes, microbiological study outcomes, administered antifungal treatment, surgical interventions, and survival following diagnosis. Results Seventeen patients were included in our study. The mean age was 55 years, with 12 males and 5 females. The most frequents underlying conditions were hematological malignancies (76.5%) and solid organ transplantation (11.8%). Surgical interventions were performed on 15 patients (88%), with 6 patients (35.3%) requiring a second intervention and 2 patients (11.8%) undergoing at least 3 interventions.3% patients succumbed to causes directly related to rhinosinusitis, with an average survival of 22 days, and 52.9% patients subsequently passed away due to complications related to their underlying condition, with an average survival of 171 days. Mid-term overall mortality was 88.2%, with an average survival of 111 days. Conclusion A shift in the patient profile was observed. Less fulminant courses have been evidenced, being oncohematotological disease and solid organ transplantation the main predisposing conditions, instead of poorly controlled diabetes. Even if direct mortality rates from AIFR are reduced (around 35%), the overall mortality rate of these patients is close to 90% with a median survival of less than 6 months. Then, an intense focus on the underlying disease and related complications is essential.https://doi.org/10.1186/s43163-024-00750-xAcute invasive fungal rhinosinusitisMucormycosisOncohematological diseaseLeukemiaOrbital exenteration |
| spellingShingle | Raúl Mellidez-Acosta Lidia Torres-García Miguel Saro-Buendía Natalia Jaramillo-Ángel Javier Cabrera-Guijo Catalina Bancalari-Díaz Noelia Muñoz-Fernández Lucas Fito-Martorell Miguel Armengot-Carceller Alfonso García-Piñero Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center The Egyptian Journal of Otolaryngology Acute invasive fungal rhinosinusitis Mucormycosis Oncohematological disease Leukemia Orbital exenteration |
| title | Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center |
| title_full | Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center |
| title_fullStr | Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center |
| title_full_unstemmed | Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center |
| title_short | Shift in the profile and prognostic implications in invasive fungal rhinosinusitis: experience of 10 years in a tertiary center |
| title_sort | shift in the profile and prognostic implications in invasive fungal rhinosinusitis experience of 10 years in a tertiary center |
| topic | Acute invasive fungal rhinosinusitis Mucormycosis Oncohematological disease Leukemia Orbital exenteration |
| url | https://doi.org/10.1186/s43163-024-00750-x |
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