Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences
Background: Invasive fungal rhinosinusitis (IFS) is a rare but often fatal disease. There are limited studies regarding IFS with orbital complications (IFSwOC). The present study aimed to identify the clinical signs associated with IFSwOC and prognosticators of the disease. Methods: A retrospective...
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MDPI AG
2021-07-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/7/573 |
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| author | Kuan-Hsiang Twu Ying-Ju Kuo Ching-Yin Ho Edward C. Kuan Wei-Hsin Wang Ming-Ying Lan |
| author_facet | Kuan-Hsiang Twu Ying-Ju Kuo Ching-Yin Ho Edward C. Kuan Wei-Hsin Wang Ming-Ying Lan |
| author_sort | Kuan-Hsiang Twu |
| collection | DOAJ |
| description | Background: Invasive fungal rhinosinusitis (IFS) is a rare but often fatal disease. There are limited studies regarding IFS with orbital complications (IFSwOC). The present study aimed to identify the clinical signs associated with IFSwOC and prognosticators of the disease. Methods: A retrospective case series was conducted of patients histopathologically confirmed IFS or fungal rhinosinusitis with clinically apparent neuro-orbital complications who underwent surgery between 2008 and 2018. Demographic data, presenting symptoms and signs, culture data, laboratory results, and patient outcomes were obtained from medical records. Results: A total of 38 patients were identified, including 9 patients with IFSwOC, and 29 patients with IFS without orbital complications (IFSsOC). The clinical signs associated with developing orbital complications include headache, fever, sphenoid sinus, or posterior ethmoid sinus involvement, CRP level ≥ 1.025 mg/dL, or ESR level ≥ 46.5 mm/h. In IFSwOC group, male, posterior ethmoid sinus involvement, WBC count ≥ 9000 μL, CRP level ≥ 6.91 mg/dL, or ESR level ≥ 69 mm/h were correlated with a significantly poorer prognosis. Conclusion: IFS patients with sphenoid or posterior ethmoid sinus involvement, headache or fever as presenting symptoms, elevated CRP, and ESR level were at risk of developing orbital complications. Timely surgical debridement followed by systemic antifungal treatment may improve treatment outcomes. |
| first_indexed | 2024-03-10T09:35:29Z |
| format | Article |
| id | doaj.art-9268c52f583c4d6c9754c0074b8a3c23 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T09:35:29Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-9268c52f583c4d6c9754c0074b8a3c232023-11-22T04:10:16ZengMDPI AGJournal of Fungi2309-608X2021-07-017757310.3390/jof7070573Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory DifferencesKuan-Hsiang Twu0Ying-Ju Kuo1Ching-Yin Ho2Edward C. Kuan3Wei-Hsin Wang4Ming-Ying Lan5Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanDepartment of Otolaryngology-Head and Neck Surgery, University of California, Irvine, CA 92868, USASchool of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, TaiwanDepartment of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 11217, TaiwanBackground: Invasive fungal rhinosinusitis (IFS) is a rare but often fatal disease. There are limited studies regarding IFS with orbital complications (IFSwOC). The present study aimed to identify the clinical signs associated with IFSwOC and prognosticators of the disease. Methods: A retrospective case series was conducted of patients histopathologically confirmed IFS or fungal rhinosinusitis with clinically apparent neuro-orbital complications who underwent surgery between 2008 and 2018. Demographic data, presenting symptoms and signs, culture data, laboratory results, and patient outcomes were obtained from medical records. Results: A total of 38 patients were identified, including 9 patients with IFSwOC, and 29 patients with IFS without orbital complications (IFSsOC). The clinical signs associated with developing orbital complications include headache, fever, sphenoid sinus, or posterior ethmoid sinus involvement, CRP level ≥ 1.025 mg/dL, or ESR level ≥ 46.5 mm/h. In IFSwOC group, male, posterior ethmoid sinus involvement, WBC count ≥ 9000 μL, CRP level ≥ 6.91 mg/dL, or ESR level ≥ 69 mm/h were correlated with a significantly poorer prognosis. Conclusion: IFS patients with sphenoid or posterior ethmoid sinus involvement, headache or fever as presenting symptoms, elevated CRP, and ESR level were at risk of developing orbital complications. Timely surgical debridement followed by systemic antifungal treatment may improve treatment outcomes.https://www.mdpi.com/2309-608X/7/7/573invasive fungal rhinosinusitisorbital complicationsfungal rhinosinusitis<i>Aspergillus</i>Mucor |
| spellingShingle | Kuan-Hsiang Twu Ying-Ju Kuo Ching-Yin Ho Edward C. Kuan Wei-Hsin Wang Ming-Ying Lan Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences Journal of Fungi invasive fungal rhinosinusitis orbital complications fungal rhinosinusitis <i>Aspergillus</i> Mucor |
| title | Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences |
| title_full | Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences |
| title_fullStr | Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences |
| title_full_unstemmed | Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences |
| title_short | Invasive Fungal Rhinosinusitis with and without Orbital Complications: Clinical and Laboratory Differences |
| title_sort | invasive fungal rhinosinusitis with and without orbital complications clinical and laboratory differences |
| topic | invasive fungal rhinosinusitis orbital complications fungal rhinosinusitis <i>Aspergillus</i> Mucor |
| url | https://www.mdpi.com/2309-608X/7/7/573 |
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