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Invasive sinonasal disease due to dematiaceous fungi in immunocompromised individuals: case report and review of the literature.
MedLine Citation:
PMID:  20594890     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Invasive dematiaceous fungal sinusitis is an uncommon and aggressive disease in immunocompromised individuals. We report a unique case of invasive Exserohilum sinusitis in a pregnant, immunocompromised woman. After treating the woman with pregnancy-induced aplastic anemia and invasive Exserohilum sinusitis and pulmonary disease, we performed a Medline/PubMed review of invasive dematiaceous fungal sinonasal disease in immunocompromised individuals. Twelve cases of proven and one case of probable invasive sinonasal dematiaceous fungal disease in immunocompromised patients are reported in the English-language literature. The majority of patients had underlying hematological conditions. The crude mortality was high, with over half of the patients dying from presumed complications of the underlying immunosuppression. Successful outcomes were associated with surgical debridement, aggressive antifungal use, and a reduction of immunosuppression. The optimal treatment for immunocompromised patients with invasive dematiaceous fungal disease is not known. The role of newer triazoles, posaconazole and voriconazole, appears promising, however more clinical data are needed. Definitive diagnosis requires tissue biopsy and successful treatment is associated with reduction of immunosuppression, aggressive surgical debulking, and systemic antifungal therapy.
Authors:
Catherine Derber; Kara Elam; Gonzalo Bearman
Publication Detail:
Type:  Journal Article     Date:  2010-07-01
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  14 Suppl 3     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e329-32     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Medicine, Division of Infectious Diseases, Virginia Commonwealth University Medical Center, 1101 East Marshall Street, Richmond, VA 23298-0049, USA.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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