INVASIVE FUNGAL SINUSITIS FOLLOWING LIVER OR BONE-MARROW TRANSPLANTATION

Invasive fungal infection of the nose and paranasal sinuses occurs alm ost exclusively in immunocompromised patients and is increasingly reco gnized as a complication of organ transplantation. We performed a retr ospective chart review of 955 bone marrow and 749 liver transplant pat ients to identify risk factors, presenting signs and symptoms, methods of diagnosis, and successful management strategies. We report on five cases following bone marrow transplantation and one case following li ver transplantation. Neutropenia is the single most important risk fac tor in the development of and recovery from invasive fungal sinusitis. Early diagnosis, combined with antifungal agents, hematopoietic growt h factors, and aggressive surgical debridement is the most effective m eans of management.