An approach to fulminant invasive fungal rhinosinusitis in the immunocompromised host

M. Boyd Gillespie, Bert W. O'Malley, Howard W. Francis

Research output: Contribution to journalArticlepeer-review

132 Scopus citations


Objective: To examine the pathogenesis of fulminant invasive fungal rhinosinusitis to determine factors that may affect patient survival. Methods: Retrospective chart review of 25 patients treated for invasive fungal rhinosinusitis over a 10-year period at an academic tertiary referral center. Evaluation of the medical and surgical records, radiographic studies, surgical pathology specimens, and culture results allowed for a multifactorial comparison between survivors and nonsurvivors. Survivors were patients who left the hospital with the invasive fungal disease stable or cured. Results: Fungal invasion often occurs within the nasal cavity (92% of patients), most commonly at the middle turbinate (62% of patients receiving biopsy). Survivors had complete surgical resection more often than nonsurvivors (90% vs 0%), and were more likely to respond to granulocyte colony-stimulating factor than nonsurvivors (100% vs 0% of those treated). Conclusions: Rigid nasal endoscopy with frozen section biopsy of suspicious nasal lesions and high-incidence areas (ie, middle turbinate) allows for the timely diagnosis of invasive fungal rhinosinusitis. Survival improves if the disease is limited to the nasal or sinus cavities, which may represent an earlier stage of disease. Favorable prognostic signs include the ability to achieve a complete surgical resection and a positive response to granulocyte colony-stimulating factor in the neutropenic patient.

Original languageEnglish (US)
Pages (from-to)520-526
Number of pages7
JournalArchives of Otolaryngology--Head and Neck Surgery
Issue number5
StatePublished - May 1998

ASJC Scopus subject areas

  • Otorhinolaryngology


Dive into the research topics of 'An approach to fulminant invasive fungal rhinosinusitis in the immunocompromised host'. Together they form a unique fingerprint.

Cite this