TITLE:
Invasive Fungal Sinusitis in Immunocompromised Patients: A Multicenter, University Hospital Experience in Shiraz
AUTHORS:
Mohsen Moghadami, Hossein Ruzbahani, Parisa Badiee, Abolhassan Faramarzi, Payam Peymani, Kamran Bagheri Lankarani
KEYWORDS:
Fungal Sinusitis; Mucor Mycosis; Aspergillus; Invasive Fungal
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.4,
December
6,
2013
ABSTRACT:
Objective: It is to determine
the causes of invasive fungal sinusitis in patients of Shiraz University
hospitals, Iran. Methods: This cross-sectional study was conducted during 18 months (from 21
March 2009 till 22 September 2010) in three Shiraz University Hospitals. Thirty-six patients with sings of invasive fungal sinusitis
were enrolled, and tissue samples were investigated for histopathology, culture
and antifungal susceptibility test. The laboratory results with host factor and
sinus computed tomography scan were evaluated for classification of patients as
proven, probable and possible invasive fungal sinusitis. Results: Thirty-five patients have involved with at least one risk
factor (immune compromised disease, diabetes mellitus, or use of immune
suppressed drugs). Radiological findings of parasinus invasion or necrosis were
present in 20 patients. By histopathology, 21 patients were considered as proven, from these, 17 samples had positive growth. The culture aetiology
agents were 4 Candida, 8 Aspergillus, and 5 Mucor. All positive culture samples
were matched with histopathology findings. Significant associations were considered for radiologic finding and histopathology
and culture (p 0.05). From 8
patients with mucormycosis histopathology, 6 suffered from diabetes mellitus.
None of the antifungal agents were effective on these three types of
infections. Conclusion: DM is the most common predisposing factor for IFS
followed by ALL and AML. The most common aetiology of IFS was found to be
Aspergillus fumigant followed by Mucormycosis
and Candida. None of antifungal agents could
successfully cover all the species.