Curvularia Sinusitis in Leukemic Patients Two Case Reports and Review of the Literature
Infectious Diseases in Clinical Practice
; 30(2), 2022.
Article
in English
| EMBASE | ID: covidwho-1769446
ABSTRACT
Curvularia species are dematiaceous filamentous fungi that can cause a variety of infections in both immunocompetent and immunocompromised hosts. We present 2 cases of severely immunosuppressed patients with acute invasive fungal sinusitis due to Curvularia species. Both patients had a history of hematologic malignancy with refractory disease and prolonged neutropenia. They presented with facial and sinus pain, which prompted maxillofacial computed tomography that showed acute sinusitis. Subsequently, they underwent nasal endoscopy with a biopsy that revealed a definitive diagnosis of invasive fungal sinusitis. Dematiaceous fungi are responsible for most fungal sinusitis cases, with Curvularia being one of the most common species isolated. Generally, invasive fungal rhinosinusitis may follow a relatively innocuous and nonspecific course. In addition, fungal infections may complicate chronic allergic sinusitis. Computed tomography scan is the first imaging modality of choice, and magnetic resonance imaging has a role in prognostication in acute invasive fungal rhinosinusitis. Endoscopic sinus surgery with biopsy yields a definitive diagnosis and is therapeutic. Management typically includes a combination of surgery and antifungal agents. Severe neutropenia is a significant risk factor for infection and is associated with poor outcomes. Aggressive surgical debridement, combined with antifungal therapy, should be emphasized in leukemic patients despite their prolonged neutropenia and bleeding tendency.
aciclovir; amoxicillin plus clavulanic acid; amphotericin B lipid complex; azithromycin; cefepime; ciprofloxacin; decitabine; doxycycline; fluconazole; hydroxyurea; isavuconazole; isavuconazonium; metronidazole; piperacillin plus tazobactam; ruxolitinib; vancomycin; venetoclax; voriconazole; acute myeloid leukemia; acute sinusitis; adult; allogeneic hematopoietic stem cell transplantation; article; blood cell count; blood clot; blood examination; bone marrow biopsy; cancer patient; case report; cellulitis; chemotherapy; chronic cluster headache; clinical article; Complete metabolic panel; computer assisted tomography; coronavirus disease 2019; Curvularia; donor lymphocyte infusion; drug substitution; drug withdrawal; dry cough; endoscopic sinus surgery; exertional dyspnea; eye pain; face pain; fatigue; febrile neutropenia; female; frontal sinus; graft failure; ground glass opacity; human; human tissue; hypokalemia; hyponatremia; immunocompromised patient; immunosuppressive treatment; leukemia; loss of appetite; lymphadenopathy; male; middle aged; mycosis; myelofibrosis; nasal biopsy; nasal endoscopy; necrotizing esophagitis; neutrophil count; nose cavity; nuclear magnetic resonance imaging; pancytopenia; paranasal sinus; phaeohyphomycosis; pleura effusion; pneumonia; postoperative complication; prophylaxis; rhinosinusitis; sepsis; sinus headache; sinus pain; sinusitis; surgical debridement; thrombocytopenia; tooth abscess; tooth periapical disease; weakness
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Case report
Language:
English
Journal:
Infectious Diseases in Clinical Practice
Year:
2022
Document Type:
Article
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