INVASIVE MOLD SINUSITIS - 17 CASES IN IMMUNOCOMPROMISED PATIENTS AND REVIEW OF THE LITERATURE

A 10-year retrospective analysis of invasive mold infections in hospit alized patients was performed to characterize the epidemiology and cli nical features of invasive fungal sinusitis. Seventeen cases of invasi ve mold sinusitis were identified. Eleven cases were caused by Aspergi llus flavus, three were caused by unspecified species, and one each wa s caused by Aspergillus fumigatus, Rhizopus species, and Alternaria sp ecies, respectively. Fifteen patients had hematologic malignancies, an d two had end-stage liver disease. The most common presenting symptom was periorbital swelling (seven patients). Sinusitis was diagnosed a m edian of 19 days after admission. Eight patients (47%) survived; six o f these patients were treated with both amphotericin B and surgery. Po stmortem examination of six patients showed evidence of disseminated d isease; the brain was the most common extrapulmonary site (four patien ts). To our knowledge, this is the largest currently reported series o n invasive mold sinusitis; our report extends the information on invas ive mold sinusitis and shows that aggressive therapeutic and surgical interventions are needed to prevent rapid progression of disease in im munocompromised patients.