Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review
<i>Alternaria</i> spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by <i>Alternaria alternata</i>, is reported in a patient with acute lymphoblastic leukemia (...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/8/879 |
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| author | Giorgos Tyrellis Maria Siopi Danai Leventakou Alexander Delides Pavlos Maragkoudakis George Korres Christina Apostolopoulou Alina-Roxani Gouloumi Vasiliki Pappa Spyros Pournaras Ioannis Panayiotides Joseph Meletiadis |
| author_facet | Giorgos Tyrellis Maria Siopi Danai Leventakou Alexander Delides Pavlos Maragkoudakis George Korres Christina Apostolopoulou Alina-Roxani Gouloumi Vasiliki Pappa Spyros Pournaras Ioannis Panayiotides Joseph Meletiadis |
| author_sort | Giorgos Tyrellis |
| collection | DOAJ |
| description | <i>Alternaria</i> spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by <i>Alternaria alternata</i>, is reported in a patient with acute lymphoblastic leukemia (ALL) on anidulafungin therapy, who was successfully treated with liposomal amphotericin B and surgical intervention. To date, 20 cases of AIFRS due to <i>Alternaria</i> spp. have been described, 19 in the USA and 1 in Chile, making this case report the first case of AIFRS due to <i>Alternaria</i> in Europe. The patients had median (range) age 25 (2–56) years (65% female), almost all of them (19/20) with hematological diseases and severe neutropenia (8–41 days pre-infection). Amphotericin B was the most frequently used antifungal agent, either alone or in combination. In all of the cases, systemic antifungal therapy was combined with surgery. Despite stabilization or improvement of the AIFRS, mortality was 38% (5 days to 8 months post-surgical debridement) due to their underlying disease or other infections without sign of AIFRS at autopsy. |
| first_indexed | 2024-03-09T13:08:43Z |
| format | Article |
| id | doaj.art-7116064545a444c9a385f2ba15e76d22 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-09T13:08:43Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-7116064545a444c9a385f2ba15e76d222023-11-30T21:45:25ZengMDPI AGJournal of Fungi2309-608X2022-08-018887910.3390/jof8080879Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature ReviewGiorgos Tyrellis0Maria Siopi1Danai Leventakou2Alexander Delides3Pavlos Maragkoudakis4George Korres5Christina Apostolopoulou6Alina-Roxani Gouloumi7Vasiliki Pappa8Spyros Pournaras9Ioannis Panayiotides10Joseph Meletiadis112nd Otolaryngology Department, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceClinical Microbiology Laboratory, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Pathology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Otolaryngology Department, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Otolaryngology Department, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Otolaryngology Department, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Internal Medicine, Hematology Unit, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Pathology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Internal Medicine, Hematology Unit, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceClinical Microbiology Laboratory, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece2nd Department of Pathology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, GreeceClinical Microbiology Laboratory, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece<i>Alternaria</i> spp. have emerged as opportunistic pathogens particularly in immunosuppressed patients. A case of a breakthrough acute invasive fungal rhinosinusitis (AIFRS), caused by <i>Alternaria alternata</i>, is reported in a patient with acute lymphoblastic leukemia (ALL) on anidulafungin therapy, who was successfully treated with liposomal amphotericin B and surgical intervention. To date, 20 cases of AIFRS due to <i>Alternaria</i> spp. have been described, 19 in the USA and 1 in Chile, making this case report the first case of AIFRS due to <i>Alternaria</i> in Europe. The patients had median (range) age 25 (2–56) years (65% female), almost all of them (19/20) with hematological diseases and severe neutropenia (8–41 days pre-infection). Amphotericin B was the most frequently used antifungal agent, either alone or in combination. In all of the cases, systemic antifungal therapy was combined with surgery. Despite stabilization or improvement of the AIFRS, mortality was 38% (5 days to 8 months post-surgical debridement) due to their underlying disease or other infections without sign of AIFRS at autopsy.https://www.mdpi.com/2309-608X/8/8/879invasive necrotizing rhinosinusitis<i>Alternaria</i> spp.breakthrough |
| spellingShingle | Giorgos Tyrellis Maria Siopi Danai Leventakou Alexander Delides Pavlos Maragkoudakis George Korres Christina Apostolopoulou Alina-Roxani Gouloumi Vasiliki Pappa Spyros Pournaras Ioannis Panayiotides Joseph Meletiadis Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review Journal of Fungi invasive necrotizing rhinosinusitis <i>Alternaria</i> spp. breakthrough |
| title | Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review |
| title_full | Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review |
| title_fullStr | Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review |
| title_full_unstemmed | Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review |
| title_short | Breakthrough Acute Necrotizing Invasive Fungal Rhinosinusitis by <i>Alternaria</i><i>alternata</i> in a Patient with Acute Lymphoblastic Leukemia on Anidulafungin Therapy and Case-Based Literature Review |
| title_sort | breakthrough acute necrotizing invasive fungal rhinosinusitis by i alternaria i i alternata i in a patient with acute lymphoblastic leukemia on anidulafungin therapy and case based literature review |
| topic | invasive necrotizing rhinosinusitis <i>Alternaria</i> spp. breakthrough |
| url | https://www.mdpi.com/2309-608X/8/8/879 |
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