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J Formos Med Assoc ; 123(3): 357-365, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37714767

RESUMEN

BACKGROUND: Acute invasive fungal rhinosinusitis (AIFR) is a potentially lethal infection commonly found in immunocompromised patients. It is considered the most aggressive subtype of fungal sinusitis and can lead to severe morbidity and mortality. There was a significant increase in the incidence of AIFR in post-COVID-19 patients compared to AIFR cases before the COVID-19 pandemic. This study aimed to describe the clinical presentation of AIFR associated with COVID-19 illness. METHODS: A retrospective study included 22 patients diagnosed with AIFR with a recent COVID-19 infection. RESULTS: The most frequent disease associated with AIFR was diabetes mellitus (95.5%). The mycological analysis identified infection caused by Aspergillus species in 72.7% of patients. Along with stabilizing hemodynamic parameters and controlling any comorbidities, all patients in the present study underwent combined surgical debridement followed by antifungal medications. The overall survival rate was 72.7%. The chance of developing a fatal outcome was significantly higher if meningitis presented initially (odds ratio 35.63, p < 0.05). CONCLUSION: The presence of meningitis upon initial diagnosis is related to a significantly higher chance of developing a fatal outcome and should be considered, especially in AIFR patients previously treated for COVID-19 infections. Early diagnosis, early use of antifungal agents, aggressive surgical debridement, and control of comorbid conditions remain crucial in managing AIFR.


Asunto(s)
COVID-19 , Meningitis , Rinitis , Rinosinusitis , Sinusitis , Humanos , Estudios Retrospectivos , Vietnam , Pandemias , Rinitis/epidemiología , Rinitis/terapia , COVID-19/complicaciones , Sinusitis/epidemiología , Sinusitis/microbiología , Enfermedad Aguda , Antifúngicos/uso terapéutico , Meningitis/tratamiento farmacológico
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