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Aggressive invasive fungal sinusitis.


Invasive sinonasal fungal fun·gous (-gs)
adj.
1. Of, relating to, resembling, or characteristic of a fungus.
2. Caused by a fungus.
 disease is a potentially fatal process when it involves intracranial intracranial /in·tra·cra·ni·al/ (-kra´ne-al) within the cranium.

in·tra·cra·ni·al (ntr
 extension. Even though this invasive disease is relatively rare, its incidence is now higher than it once was because of the increased number of immunosuppressed patients. [1,2] However, in the case presented here, that of a black 13-year-old girl, the patient had no clinical evidence of immunosuppression immunosuppression /im·mu·no·sup·pres·sion/ (-sah-presh´un) prevention or diminution of the immune response, such as by radiation, antimetabolites, or specific antibody.immunosuppres´sive

im·mu·no·sup·pres·sion (
.

Computed tomography (CT) revealed that she had an extensive invasive allergic fungal rhinosinusitis rhinosinusitis /rhi·no·si·nu·si·tis/ (ri?no-si?nu-si´tis) inflammation of the paranasal sinuses. (figure 1). A biopsy revealed aspergillosis aspergillosis /as·per·gil·lo·sis/ (-o´sis) a disease caused by species of Aspergillus, marked by inflammatory granulomatous lesions in the skin, ear, orbit, nasal sinuses, lungs, bones, and meninges.

as·per·gil·lo·sis (
. On magnetic resonance imaging (MRI), extensive intraorbital involvement and early intracranial extension were demonstrated (figure 2). This finding prompted aggressive management with surgical debridement and systemic antifungal therapy.

From the Department of Radiology, Louisiana State University Health Science Center, New Orleans (Dr. Palacios and Dr. D'Antonio), and the Department of Radiology and Otolaryngology, University of Illinois Medical Center, Chicago (Dr. Valvassori).

References

(1.) Houser SM, Corey JP. Allergic fungal rhinosinusitis: Pathophysiology
1. The functional changes associated with or resulting from disease or injury.
2. The study of such changes. Also called physiopathology.

patho·physi·o·log, epidemiology, and diagnosis. Otolaryngol Clin North Am 2000;33:399-409.

(2.) Rizk SS, Kraus DH, Gerresheim G, Mudan S. Aggressive combination treatment for invasive fungal sinusitis in immunocompromised immunocompromised /im·mu·no·com·pro·mised/ (-kom´pro-mizd) having the immune response attenuated by administration of immunosuppressive drugs, by irradiation, by malnutrition, or by certain disease processes (e.g., cancer).

im·mu·no·com·pro·mised (
 patients. Ear Nose Throat J 2000;79:278-80, 282, 284-5.
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Article Details
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Author:D'Antonio, Michael
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Nov 1, 2000
Words:189
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