ASPERGILLUS SINUSITIS IN PATIENTS WITH AIDS - REPORT OF 3 CASES AND REVIEW

Invasive aspergillosis is an uncommon but increasingly reported compli cation of AIDS. Sinusitis, usually bacterial in etiology, is frequentl y seen among human immunodeficiency virus (HIV)-infected patients. We discuss the cases of three patients with AIDS and invasive aspergillus sinusitis seen at our institutions and those of 15 patients who are d escribed in the literature. Seven of the 18 had brain involvement, 3 h ad orbital involvement, and 7 had mastoid or other bony disease. Three had evidence of concomitant invasive pulmonary aspergillosis. Of 15 p atients with evaluable histories, 11 had recognized risks for invasive aspergillosis; 6 had previous sinusitis, otitis, or polyposis; and 11 had prior conditions indicative of advanced HIV-related disease. Desp ite aggressive surgical intervention and systemic antifungal therapy, nearly all patients died as a result of aspergillosis.