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. 2022 Jan-Mar;44(1):32-39.
doi: 10.1016/j.htct.2020.08.016. Epub 2020 Nov 9.

Acute invasive fungal rhinosinusitis in pediatric patients with oncohematological diseases

Lorrane Caroline Braga Rodrigues  1 , Alessandro Fernandes Guimaraes  1 , Isamara Simas de Oliveira  1 , Pedro Henrique Medici de Sousa  1 , Roberta Maia de Castro Romanelli  1 , Fabiana Maria Kakehasi  1 , Karla Emília de Sá Rodrigues  2
Affiliations

Acute invasive fungal rhinosinusitis in pediatric patients with oncohematological diseases

Lorrane Caroline Braga Rodrigues et al. Hematol Transfus Cell Ther. 2022 Jan-Mar.

Abstract

Introduction: Invasive fungal diseases represent important causes of morbidity and mortality among pediatric oncohematological patients. Acute invasive fungal rhinosinusitis is a rare and aggressive disease that occurs mainly in immunocompromised patients. The mortality rate is high and therefore, accurate and early diagnosis is essential.

Objectives: The aim of this study was to describe the frequency of acute invasive fungal rhinosinusitis among pediatric oncohematological patients and characterize them with confirmed diagnoses.

Methods: This was a retrospective study that analyzed the medical records of pediatric patients diagnosed with oncohematological diseases and suspected fungal infections, who were included after obtaining informed consent, from January to December 2017, in the pediatric unit of a tertiary university hospital. Data collected from medical record analysis included the following: underlying diagnosis, absolute neutrophil count, clinical presentation, culture and biopsy results, surgical procedures performed, survival and mortality.

Results: A total of 27 patients were evaluated, with three suspected cases of acute invasive fungal rhinosinusitis. Histopathological and microbiological analyses confirmed two cases. In both cases, the pathogen isolated in the culture was Fusarium sp. The two confirmed cases were female, aged 12 and 14 years, both with an absolute neutrophil count of 10cells/μL. The underlying disease of the first patient was acute myeloid leukemia (subtype M5), whereas the second patient presented idiopathic bone marrow aplasia.

Conclusion: Both confirmed cases of acute invasive fungal rhinosinusitis presented with constitutional symptoms and signs of nasal and sinusital inflammation. This demonstrates the importance of fever as a symptom in immunocompromised patients and it should prompt otorhinolaryngological investigation.

Keywords: Febrile neutropenia; Fusarium; Hematologic diseases; Invasive fungal infection; Pediatrics.

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Figure 1
Flowchart for management of neutropenic patients suspected of invasive fungal infection.
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References

    1. Saffioti C., Mesini A., Bandettini R., Castagnola E. Diagnosis of invasive fungal disease in children: a narrative review. Expert Rev Anti Infect Ther. 2019;13:1–15. - PubMed
    1. deShazo R.D., O’Brien M., Chapin K., Soto-Aguilar M., Gardner L., Swain R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg. 1997;123:1181–1188. - PubMed
    1. Pignatari S.S.N., Anselmo-Lima W.T. Elsevier; Rio de Janeiro: 2018. Otorhinolaryngology treaty.
    1. Wiley A., Schell M.S. Histopathology of fungal rhinosinusitis. Otolaryngol Clin North Am. 2000;33 251–27. - PubMed
    1. Chen C.Y., Sheng W.H., Cheng A., Chen C.Y., Tsay W., Tang J.L., et al. Invasive fungal sinusitis in patients with hematological malignancy: 15 years experience in a single university hospital in Taiwan. BMC Infect Dis. 2011;11:250–259. - PMC - PubMed