Cargando…
“Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report”
INTRODUCTION AND IMPORTANCE: Granulomatous chronic invasive fungal rhinosinusitis (GCIFR) is a rare entity with scarce cases reported mainly in subtropical areas. Its prevalence among individuals with clinical suspicion of fungal rhinosinusitis has been reported in approximately 20% in subtropical p...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636311/ https://www.ncbi.nlm.nih.gov/pubmed/34873446 http://dx.doi.org/10.1016/j.amsu.2021.103129 |
_version_ | 1784608510362779648 |
---|---|
author | Treviño-Gonzalez, Jose Luis Santos-Santillana, Karla Marisol Maldonado-Chapa, Felix Morales-Del Angel, Josefina Alejandra Gomez-Castillo, Paola Cortes-Ponce, Jose Rosmal |
author_facet | Treviño-Gonzalez, Jose Luis Santos-Santillana, Karla Marisol Maldonado-Chapa, Felix Morales-Del Angel, Josefina Alejandra Gomez-Castillo, Paola Cortes-Ponce, Jose Rosmal |
author_sort | Treviño-Gonzalez, Jose Luis |
collection | PubMed |
description | INTRODUCTION AND IMPORTANCE: Granulomatous chronic invasive fungal rhinosinusitis (GCIFR) is a rare entity with scarce cases reported mainly in subtropical areas. Its prevalence among individuals with clinical suspicion of fungal rhinosinusitis has been reported in approximately 20% in subtropical populations, unlike North America with a prevalence of 0.5%. It is typically associated with Aspergillus flavus and the presence of noncaseating granulomas or Langerhans giant cells on histopathologic examination. CASE PRESENTATION: We describe a case of a patient with clinical history of recent SARS-CoV-2 infection and development of intense cephalalgia, visual impairment, palpebral ptosis, and limitation of extraocular movements. MRI demonstrated the presence of opacification of paranasal sinuses, and a left intraconal abscess. A surgical endoscopic approach was performed and histopathologic examination revealed frontal GCIFR and maxillary fungus ball. Treatment with IV azoles provided adequate clinical response. CLINICAL DISCUSSION: The spectrum of the fungal rhinosinusitis disease is not clear. However, non-invasive fungal rhinosinusitis is not often found concomitantly with invasive types. GCIFR typically manifests with an indolent and gradual progression at early stages. Advanced stages can exhibit orbital and intracranial involvement leading to visual impairment, frequent relapses, and a poor prognosis. A higher incidence of invasive fungal rhinosinusitis has been reported in patients with SARS-CoV-2 infection despite an unremarkable medical history, associated with immune dysregulation. CONCLUSION: GCIFR is a rare condition with few cases reported in America. Because of its uncommonness, its diagnosis is often delayed leading to increased morbidity and mortality. |
format | Online Article Text |
id | pubmed-8636311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-86363112021-12-02 “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” Treviño-Gonzalez, Jose Luis Santos-Santillana, Karla Marisol Maldonado-Chapa, Felix Morales-Del Angel, Josefina Alejandra Gomez-Castillo, Paola Cortes-Ponce, Jose Rosmal Ann Med Surg (Lond) Case Report INTRODUCTION AND IMPORTANCE: Granulomatous chronic invasive fungal rhinosinusitis (GCIFR) is a rare entity with scarce cases reported mainly in subtropical areas. Its prevalence among individuals with clinical suspicion of fungal rhinosinusitis has been reported in approximately 20% in subtropical populations, unlike North America with a prevalence of 0.5%. It is typically associated with Aspergillus flavus and the presence of noncaseating granulomas or Langerhans giant cells on histopathologic examination. CASE PRESENTATION: We describe a case of a patient with clinical history of recent SARS-CoV-2 infection and development of intense cephalalgia, visual impairment, palpebral ptosis, and limitation of extraocular movements. MRI demonstrated the presence of opacification of paranasal sinuses, and a left intraconal abscess. A surgical endoscopic approach was performed and histopathologic examination revealed frontal GCIFR and maxillary fungus ball. Treatment with IV azoles provided adequate clinical response. CLINICAL DISCUSSION: The spectrum of the fungal rhinosinusitis disease is not clear. However, non-invasive fungal rhinosinusitis is not often found concomitantly with invasive types. GCIFR typically manifests with an indolent and gradual progression at early stages. Advanced stages can exhibit orbital and intracranial involvement leading to visual impairment, frequent relapses, and a poor prognosis. A higher incidence of invasive fungal rhinosinusitis has been reported in patients with SARS-CoV-2 infection despite an unremarkable medical history, associated with immune dysregulation. CONCLUSION: GCIFR is a rare condition with few cases reported in America. Because of its uncommonness, its diagnosis is often delayed leading to increased morbidity and mortality. Elsevier 2021-12-02 /pmc/articles/PMC8636311/ /pubmed/34873446 http://dx.doi.org/10.1016/j.amsu.2021.103129 Text en © 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Treviño-Gonzalez, Jose Luis Santos-Santillana, Karla Marisol Maldonado-Chapa, Felix Morales-Del Angel, Josefina Alejandra Gomez-Castillo, Paola Cortes-Ponce, Jose Rosmal “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title | “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title_full | “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title_fullStr | “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title_full_unstemmed | “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title_short | “Chronic granulomatous invasive fungal rhinosinusitis associated with SARS-CoV-2 infection: A case report” |
title_sort | “chronic granulomatous invasive fungal rhinosinusitis associated with sars-cov-2 infection: a case report” |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636311/ https://www.ncbi.nlm.nih.gov/pubmed/34873446 http://dx.doi.org/10.1016/j.amsu.2021.103129 |
work_keys_str_mv | AT trevinogonzalezjoseluis chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport AT santossantillanakarlamarisol chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport AT maldonadochapafelix chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport AT moralesdelangeljosefinaalejandra chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport AT gomezcastillopaola chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport AT cortesponcejoserosmal chronicgranulomatousinvasivefungalrhinosinusitisassociatedwithsarscov2infectionacasereport |