Sinonasal Infections in Immunocompromised Patients Undergoing Bone Marrow Transplantation / 대한이비인후과학회지

ABSTRACT

BACKGROUND: Sinonasal infection is potentially a fatal disease in the immunocompromised patients who are undergoing bone marrow transplantation(BMT). OBJECTIVES: The aim of this study is to determine the incidence, symptoms and signs, risk factors, treatment modalities and the prognostic factors of the sinonasal infections in the immunocompromised BMT patients. MATERIALS AND METHODS: We reviewed the records of 235 patients who had received bone marrow transplantation in St. Mary's hospital from December 1983 to August 1995 to determine the clinical features of sinonasal infections in these patients. RESULTS: Forty six patients(19.6%) were affected by sinonasal infections. In 40 patients(17.0%) the infection occurred before BMT. In 11 patients(4.7%), the infection occurred after BMT. Five out of 11 patients(2.1%) had previous sinonasal infections. The most common symptoms and signs were fever and rhinorrhea. Fourteen patients had no discernible symptoms or signs that suggested the presence of sinonasal infection. In our study, patients with previous history of sinonasal infection were more likely to be infected again after BMT. Medical treatment with broad-spectrum antibiotics is the initial treatment modality and surgical treatment is indicated in intractable cases. CONCLUSIONS: The immunocompromised BMT patients have high incidence of serious sinonasal infections than normal immunocompetent persons. Early detection and aggressive combined treatment with medical and surgical modalities are essential for the treatment of sinonasal infections in the BMT patients.