الفهرس | Only 14 pages are availabe for public view |
Abstract Invasive fungal sinusitis is an aggressive and often fatal angio-invasive infection of the paranasal sinuses caused by fungal organisms mostly mucormycosis family being increasingly recognized in patients with hematologic malignancies, chronic immune suppression, and poorly controlled diabetes mellitus. The presentation of IFS can be quite variable, Clinical suspicion for IFS should be raised in the immune-compromised patient presenting with fever, rapidly progressive sinusitis or facial discomfort or swelling. Nasal endoscopy will often demonstrate areas of mucosal ischemia, frank necrosis, or crusting, and radiological investigations will typically show nonspecific findings of sinus opacification. Early and accurate diagnosis is essential, as prognosis is often governed by the rapid initiation of antifungal therapy and/or surgical debridement. 20 patients diagnosed with IFS were collected, investigated, and received treatment and then followed thoroughly, 11 patients died at the end of the study and 9 of them survived. Early presentation (88.9% survived) along with controlled underlying medical disorder (100% survived) carried better outcomes with diabetics recovered better than other diseases (88.9% survived), while late presentations (11.1% survived), intracranial involvement (22.2% survived), poor control of associated diseases (0% survived) and extensive gangrene at the time of presentation (11.1% survived) carried bad prognosis. Extensive surgical debridement offered better results but not reaching the level of statistical significance (P=0.319). The survived patients had residual morbidities like loss of vision in the affected eye, loss of palate, palatal fistula and facial disfigurement. |