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Invasive fungal rhinosinusitis in immunocompromised patients
Authors:Anselmo-Lima Wilma T  Lopes Rony P  Valera Fabiana C P  Demarco Ricardo C
Institution:Department of Otorhinolaryngology, Ophthalmology and Head and Neck Surgery, Faculty of Medicine of Ribeir?o Preto, University of S?o Paulo, Brasil. mcecilia@hcrp.fmrp.usp.br
Abstract:INTRODUCTION: Invasive fungal rhinosinusitis (IFR) is one of the most important causes of morbidity and mortality in immunocompromised patients, principally those with cellular immunodeficiency, with mortality ranging from 50 to 80%. Prophylaxis and early diagnosis increase the chances of successful treatment. STUDY DESIGN: Clinical prospective randomized study. AIM: To present cases of IFR and to compare them with data reported in the literature. MATERIAL AND METHODS: Analysis of eleven cases of IFR confirmed by pathologist examination. RESULTS: Aspergillus was found to be the most prevalent pathogen. Symptoms ranged from high fever in most cases to nasal discharge, ulceration of the nasal mucosa, headache and periorbital edema. CONCLUSION: The combination of amphotericin B and endoscopic surgery, associated or not with Caldwell-Luc surgery, showed good results. The use of liposomal amphotericin B also presented a satisfactory outcome.
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