Successful treatment of invasive fungal rhinosinusitis caused by : A case report and review of the literature.

World J Clin Cases

Department of Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

Published: January 2019

Background: Invasive fungal rhinosinusitis (IFR) caused by is very rare but has an extremely high fatality rate. There have been only seven cases of IFR caused by reported in English and, of these, only three patients survived. In this article, we present another case of IFR caused by , in which the patient was initially treated successfully but then deteriorated due to a relapse of leukemia 2 mo later.

Case Summary: A 50-year-old woman presented with a 2-mo history of right ocular proptosis, blurred vision, rhinorrhea and nasal obstruction. Nasal endoscopic examination showed that the middle turbinate had become necrotic and fragile. Endoscopic sinus surgery and enucleation of the right orbital contents were performed successively. Additionally, the patient was treated with amphotericin B both systematically and topically. Secretion cultivation of the right eye canthus showed infection with , while postoperative pathology also revealed fungal infection. The patient's condition gradually stabilized after surgery. However, the patient underwent chemotherapy again due to a relapse of leukemia 2 mo later. Unfortunately, her leukocyte count decreased dramatically, leading to a fatal lung infection and hemoptysis.

Conclusion: Aggressive surgical debridements, followed by antifungal drug treatment both systematically and topically, are the most important fundamental treatments for IFR.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354086PMC
http://dx.doi.org/10.12998/wjcc.v7.i2.228DOI Listing

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