Evidence for a âpreinvasiveâ variant of fungal sinusitis: Tissue invasion without angioinvasion
Clinical experience has suggested the existence of an intermediate form of fungal sinusitis between the categories of non-invasive fungal sinusitis (non-IFS) and invasive fungal sinusitis (IFS). This fungal sinusitis variant demonstrates unhealthy mucosa by endoscopy with fungal invasion, but lacks...
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| Autores principales: | , , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
KeAi Communications Co., Ltd.
2017
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/b50c0f38ace74b9b88d7aff22a22e195 |
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| Sumario: | Clinical experience has suggested the existence of an intermediate form of fungal sinusitis between the categories of non-invasive fungal sinusitis (non-IFS) and invasive fungal sinusitis (IFS). This fungal sinusitis variant demonstrates unhealthy mucosa by endoscopy with fungal invasion, but lacks angioinvasion microscopically, representing what clinically behaves as a âpre-invasiveâ subtype of fungal sinusitis. Unlike non-IFS disease, patients with pre-invasive fungal sinusitis were still felt to require anti-fungal medications due to histologic presence of invasive fungus. While sharing some clinical features of IFS, these âintermediateâ patients were successfully spared extended and repeated surgical debridements given the microscopic findings, and have been successfully treated with shorter courses of antifungal therapy. These select patients have had favorable outcomes when managed in a judicious and semi-aggressive manner, in an undefined zone between the treatments for routine fungal ball and aggressive IFS. Keywords: Fungal sinusitis, Invasive fungal sinusitis, IFS, Chronic rhinosinusitis, Fungal ball, Visual loss, Immunocompromised, Immunosuppressed, Antifungal therapy |
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