Chronic invasive aspergillosis of the paranasal sinuses in immunocompetenthosts from Saudi Arabia

In immunocompetent patients, paranasal invasive aspergillosis is rare and h as a high recurrence rate. Twenty-three cases of paranasal invasive aspergi llosis, involving 14 male and nine female immunocompetent patients were rev iewed. All patients were cancer-free, HIV-negative, with normal WBC, and no ne of the patients had received immunosuppressive therapy or corticosteroid s. Mean duration of symptoms before diagnosis was 18 months, Aspergillus fl avus was the species most frequently isolated. Surgical debridement was per formed in all patients followed by antifungal therapy in 18 patients. Mean follow-up duration was 30 months. Fourteen patients relapsed after a mean o f 13 months and required an average of 4.3 admissions for repeat surgical e vacuation. In a logistic regression model, relapse was not associated with age, duration of symptoms, clinical findings, extent of disease, or mode of therapy. However, patients who were relapse-free tended to have had comple te surgical evacuation followed by antifungal therapy.