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Risk factors and predictors of mortality in acute invasive fungal sinusitis – a single-institution experience.
- Source :
- Journal of Laryngology & Otology; Dec2022, Vol. 136 Issue 12, p1320-1327, 8p
- Publication Year :
- 2022
-
Abstract
- Objective: To determine risk factors affecting mortality in acute invasive fungal sinusitis. Method: This observational cohort study was conducted over a five-year period. Results: Of 109 recruited patients, 90 (82.6 per cent) had diabetes mellitus. Predominant fungi were zygomycetes (72.6 per cent) with Rhizopus arrhizus being most common. Of the patients, 12.8 per cent showed a positive biopsy report from radiologically normal sinuses. Factors affecting mortality on multivariate analysis were: female sex (p = 0.022), less than two weeks between symptoms and first intervention (p = 0.01), and intracranial involvement (p = 0.034). Other factors significant on univariate analysis were: peri-orbital swelling (p = 0.016), restricted ocular movements (p = 0.053), intracranial symptoms (p = 0.008), posterior disease (p = 0.058), imaging showing ocular involvement (p = 0.041), fungus being zygomycetes (p = 0.050) and post-operative cavity infection (p = 0.032). Bilateral, palatal and retromaxillary involvement were not associated with poor prognosis. Conclusion: Diagnosis of acute invasive fungal sinusitis requires a high index of clinical suspicion. Recognition of factors associated with poor prognosis can help when counselling patients, and can help initiate urgent intervention by debridement and antifungal therapy. Post-operative nasal and sinus cavity care is important to reduce mortality. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00222151
- Volume :
- 136
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Journal of Laryngology & Otology
- Publication Type :
- Academic Journal
- Accession number :
- 160228391
- Full Text :
- https://doi.org/10.1017/S0022215122000755