BACKGROUND: Invasive Aspergillus sinusitis (IAS) is associated with high mortality and poor response to antifungal therapy in patients with hematologic malignancies (HM). PATIENTS AND METHODS: We identified 353 patients with invasive aspergillosis of whom 39 patients had IAS. Of the 39 patients, 13 underwent sinus surgery (SS) in addition to the antifungal therapy, and the remaining 26 control patients received antifungal therapy alone. Most patients with IAS had underlying leukemia (85%). Both groups had comparable clinical characteristics such as gender, age, underlying disease, neutropenia at the onset, persistent neutropenia, graft-vs-host-disease, and comparable antifungal therapy. RESULTS: Overall response was 7 (53.2%) in the SS group vs 5 (19.2%) in the control group (p = 0.06). Among the subgroup of patients with neutropenia at the onset of infection, the response rate in the SS group was significantly better than in the non-SS group (57% vs 11.8%, respectively; p = 0.028). CONCLUSION: In neutropenic patients with IAS and underlying HM, SS significantly improved the response to antifungal therapy. Additional studies are warranted.
BACKGROUND:Invasive Aspergillus sinusitis (IAS) is associated with high mortality and poor response to antifungal therapy in patients with hematologic malignancies (HM). PATIENTS AND METHODS: We identified 353 patients with invasive aspergillosis of whom 39 patients had IAS. Of the 39 patients, 13 underwent sinus surgery (SS) in addition to the antifungal therapy, and the remaining 26 control patients received antifungal therapy alone. Most patients with IAS had underlying leukemia (85%). Both groups had comparable clinical characteristics such as gender, age, underlying disease, neutropenia at the onset, persistent neutropenia, graft-vs-host-disease, and comparable antifungal therapy. RESULTS: Overall response was 7 (53.2%) in the SS group vs 5 (19.2%) in the control group (p = 0.06). Among the subgroup of patients with neutropenia at the onset of infection, the response rate in the SS group was significantly better than in the non-SS group (57% vs 11.8%, respectively; p = 0.028). CONCLUSION: In neutropenicpatients with IAS and underlying HM, SS significantly improved the response to antifungal therapy. Additional studies are warranted.
Authors: M Homeida; A F Abdel-Gadir; A W Cheever; J L Bennett; B M Arbab; S Z Ibrahium; I M Abdel-Salam; A A Dafalla; T E Nash Journal: Am J Trop Med Hyg Date: 1988-01 Impact factor: 2.345
Authors: K Ishak; A Baptista; L Bianchi; F Callea; J De Groote; F Gudat; H Denk; V Desmet; G Korb; R N MacSween Journal: J Hepatol Date: 1995-06 Impact factor: 25.083
Authors: M M Homeida; I A Eltoum; M M Ali; S M Suliaman; E A Elobied; M Mansour; A M Saad; J L Bennett Journal: Am J Trop Med Hyg Date: 1996-02 Impact factor: 2.345
Authors: Charles H King; Philip Magak; Ekram Abdel Salam; John H Ouma; H Curtis Kariuki; Ronald E Blanton Journal: Trop Med Int Health Date: 2003-02 Impact factor: 2.622
Authors: Birgitte J Vennervald; LeeCarol Kenty; Anthony E Butterworth; Curtis H Kariuki; Hilda Kadzo; Edmund Ireri; Clifford Amaganga; Gachuhi Kimani; Joseph Mwatha; Amos Otedo; Mark Booth; John H Ouma; David W Dunne Journal: Trop Med Int Health Date: 2004-04 Impact factor: 2.622