Acute Fulminant Fungal Sinusitis in Patients with Acute Leukemia

Abstract

Background: Acute fulminant fungal sinusitis is a rapidly progressive disease with high mortality (50-80%) and occurring with increasing frequency in patients with acute leukemia. The purpose of the present study was early diagnosis of this le­thal infection.
Methods: In a cross-sectional study, 142 patients with hematological malignancies were studied immediately by initiation of chemotherapy to determine early clinical and radiological findings of invasive fungal sinusitis. This infection was con­firmed by pathological and mycological methods.
Results: Acute fulminant fungal sinusitis was diagnosed in 8 patients with acute leukemia. The most common isolated fungi was Aspergillus flavus (n= 5) followed by Aspergillus fumigatus (n= 2) and Rhizopus sp. (n= 1). Despite prompt surgical and medical therapy, the disease in our patients was very aggressive with a rapid clinical course and high mortality.
Conclusion:  The present report shows the poor prognosis of invasive fungal sinusitis in neutropenic patients; the necessity to take intensive preventive measures and the application of new diagnostic methods for early detection of fungal infection in these high risk patients.