Idioma:

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

Wandell, Grace M. ; Miller, Craig ; Rathor, Aakanksha ; Wai, Travis Hee ; Guyer, Richard A. ; Schmidt, Rodney A. ; Turner, Justin H. ; Hwang, Peter H. ; Davis, Greg E. ; Humphreys, Ian M.

International forum of allergy & rhinology, 2018-12, Vol.8 (12), p.1459-1468 [Periódico revisado por pares]

United States: Wiley Subscription Services, Inc

Texto completo disponível

Citações Citado por

Enviar para

Título:
A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis
Autor: Wandell, Grace M. ; Miller, Craig ; Rathor, Aakanksha ; Wai, Travis Hee ; Guyer, Richard A. ; Schmidt, Rodney A. ; Turner, Justin H. ; Hwang, Peter H. ; Davis, Greg E. ; Humphreys, Ian M.
Assuntos: Adult ; Aged ; Aged, 80 and over ; Biopsy ; Bone marrow transplantation ; Cavernous Sinus - pathology ; Chemotherapy ; Debridement ; Diagnosis ; Female ; fungal sinusitis ; Fungi ; Humans ; Immunization ; Immunocompromised hosts ; immunotherapy ; Invasive Fungal Infections - diagnosis ; Invasive Fungal Infections - mortality ; Invasive Fungal Infections - therapy ; invasive fungal sinusitis ; Male ; Malignancy ; Medical prognosis ; Middle Aged ; orbital/ocular ; paranasal sinus diseases ; Prognosis ; Risk ; Sinus ; Sinusitis ; Sinusitis - diagnosis ; Sinusitis - mortality ; Sinusitis - therapy ; Survival Analysis ; Young Adult
É parte de: International forum of allergy & rhinology, 2018-12, Vol.8 (12), p.1459-1468
Notas: Presented at the American Rhinologic Society Spring Meeting, on April 20, 2018, in National Harbor, MD.
Potential conflict of interest: None disclosed.
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: Background Acute invasive fungal sinusitis (AIFS) is a rare, aggressive infection occurring in immunocompromised patients. In this study we examined factors that affect survival in AIFS, and whether immune‐stimulating therapies (IST) improve survival. Methods Pathology records of biopsy‐proven AIFS were reviewed from 3 academic institutions from 1995 to 2016. Univariate and multivariate Cox regressions were performed at 1 and 3 months from diagnosis. Results One hundred fourteen patients were included; 45 received IST. In the univariate analysis, the following factors were associated with worse survival: hematologic malignancy (3‐month hazard ratio [HR], 3.7; p = 0.01); recent chemotherapy (within 1 month of AIFS diagnosis) (3‐month HR, 2.3; p = 0.02); recent bone marrow transplant (BMT) (3‐month HR, 2.5; p = 0.02); and infection with atypical fungi (1‐month HR, 3.1; p = 0.04). The following were associated with improved survival in univariate analysis: increasing A1c% (1‐month HR, 0.7; p = 0.01) and surgical debridement (1‐month HR, 0.1; p = 0.001). One third of patients with a hematologic malignancy had an absolute neutrophil count (ANC) >1000 at the time of diagnosis. ANC was not associated with prognosis in these patients. The following were associated with worse survival in multivariate analyses: hematologic malignancy; recent chemotherapy; atypical organisms; and cavernous sinus extension. In multivariate analyses, IST was associated with a 70% reduction in mortality at 1 month (p = 0.02). Conclusion We presented the largest series of AIFS. Further studies are needed to examine the importance of ANC in diagnosis and prognosis. Patients diagnosed with atypical organisms may be at higher risk of death. IST likely improves short‐term survival, but prospective studies are needed.
Editor: United States: Wiley Subscription Services, Inc
Idioma: Inglês

Links

View this record in MEDLINE/PubMed

Voltar para lista de resultados

Anterior Resultado 3 Avançar Ir para próxima página

Realização: Logos de Redes Sociais:

A multi‐institutional review of outcomes in biopsy‐proven acute invasive fungal sinusitis

Wandell, Grace M. ; Miller, Craig ; Rathor, Aakanksha ; Wai, Travis Hee ; Guyer, Richard A. ; Schmidt, Rodney A. ; Turner, Justin H. ; Hwang, Peter H. ; Davis, Greg E. ; Humphreys, Ian M.

United States: Wiley Subscription Services, Inc

Buscando em bases de dados remotas. Favor aguardar.