Changing Trends in the Survival of Immunosuppressed Children with Invasive Fungal Rhinosinusitis
| العنوان: | Changing Trends in the Survival of Immunosuppressed Children with Invasive Fungal Rhinosinusitis |
|---|---|
| المؤلفون: | Amit Ritter, Shlomit Barzilai-Birenboim, Olga Gordon Rapana, Salvador Fischer, Itzhak Levy, Ethan Soudry, Dror Gilony |
| المصدر: | American journal of rhinologyallergy. 36(5) |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | Immunocompromised Host, Antifungal Agents, Otorhinolaryngology, Acute Disease, Immunology and Allergy, Aspergillosis, Humans, Mucormycosis, General Medicine, Sinusitis, Child, Rhinitis |
| الوصف: | Background Acute invasive fungal rhinosinusitis has been associated with high mortality rates. Objective We aimed to explore the contribution of novel detection and treatment methods on the outcome of immunosuppressed children with acute invasive fungal rhinosinusitis. Methods The records of all children with a hematologic or oncologic disease who developed acute invasive fungal rhinosinusitis between 2005–2020 were reviewed. Results Thirty-four patients were included. Aspergillosis and mucormycosis were diagnosed in 20 patients (59%) and 12 patients (35%), respectively. Panfungal polymerase chain reaction (PCR) was associated with a change of treatment in 36% of patients. A more aggressive surgical approach as well as treatment with liposomal amphotericin B and novel antifungals were adopted in recent years. Overall, 26% of patients died of disease, however no disease-specific death occurred since 2012. Diagnosis using panfungal PCR ( p = .04) and treatment with novel antifungal medications ( p = .017) were significantly associated with disease-specific survival. Conclusion Enhanced fungal detection using panfungal PCR and treatment with novel antifungal agents, combined with rapid diagnosis and treatment, aggressive surgical approach and better control over the underlying oncological disease, may significantly improve the outcome of immunosuppressed children with acute invasive fungal rhinosinusitis. |
| تدمد: | 1945-8932 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46151f71540f5403ebcc329912c0eb19 https://pubmed.ncbi.nlm.nih.gov/35360956 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....46151f71540f5403ebcc329912c0eb19 |
| قاعدة البيانات: | OpenAIRE |
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