Acute Invasive Fungal Rhinosinusitis in Immunocompromised Patients: Role of an Early Diagnosis
| Autor: | Paolo Farneti, Ernesto Pasquini, Martina Fornaciari, Marco Demattè, Ignacio Javier Fernandez, Francesco Maria Crocetta, Russel Edward Lewis, Vittorio Sciarretta, Marta Stanzani |
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| Přispěvatelé: | Fernandez IJ, Crocetta FM, Demattè M, Farneti P, Stanzani M, Lewis RE, Fornaciari M, Pasquini E, Sciarretta V |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Diagnostic Imaging Male Prognostic variable medicine.medical_specialty invasive fungal rhinosinusiti nasal endoscopy Time to treatment Disease Time-to-Treatment 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Internal medicine medicine Humans Clinical significance 030212 general & internal medicine Sinusitis 030223 otorhinolaryngology Aged Retrospective Studies Rhinitis business.industry Otorhinolaryngology2734 Pathology and Forensic Medicine Treatment delay Retrospective cohort study Middle Aged University hospital medicine.disease Prognosis Early Diagnosis Otorhinolaryngology Italy Mycoses early diagnosi Acute Disease hematologic malignancy Female Surgery business Biomarkers prognosi |
| Popis: | Objective The aims of the present study were to evaluate the clinical significance of the delay for surgical treatment and the prognostic value of other clinical, pathologic, and microbiological variables among hematologic patients affected by acute invasive fungal rhinosinusitis (AIFRS). Furthermore, we propose our early diagnosis and treatment protocol, reporting its 10-year results. Study Design Monocentric retrospective analysis. Setting The study was conducted from 2001 to 2017 at the University Hospital of Bologna, Italy. Subjects and Methods The impact of time to treatment and clinical, pathologic, and microbiological variables were analyzed among patients with histologically and microbiologically proven AIFRS. The outcomes of patients treated before the introduction of the early diagnosis protocol were compared with those treated afterward. Results Nineteen patients affected by AIFRS were eligible for the study. Treatment delay >4 days ( P = .002), infection caused by Mucorales ( P = .015), and extension of the disease were negative prognostic variables ( P = .017). The application of our protocol significantly reduced the delay for diagnosis and appropriate treatment by an average of 7.3 days ( P = .02). Conclusion The promptness of the diagnosis and surgical treatment may play a significant role in the management of AIFRS, as it appears to be significantly associated with the disease outcome. Our protocol may help to reduce the time required for diagnosis of high-risk hematologic patients. |
| Databáze: | OpenAIRE |
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