Early diagnosis, antifungal therapy improve outcomes in children with invasive fungal sinusitis

Children with invasive fungal sinusitis may benefit from early diagnosis, aggressive surgical intervention, and combined antifungal therapy to achieve better outcomes, suggests a study.

A group of researchers retrospectively analysed the clinical data of 12 paediatric patients diagnosed with invasive fungal sinusitis between 2021 and 2023. 

Diagnosis comprised microbiological and histopathologic examinations and radiologic imaging, while treatment included surgical intervention and antifungal therapy, with a detailed evaluation of orbital involvement. The researchers also performed a statistical analysis that included descriptive statistics and logistic regression.

Majority of the patients (median age 8 years) were males and had symptoms such as orbital swelling and impaired vision. Imaging revealed fat stranding and bone erosions as the characteristic features of invasive fungal sinusitis. Orbital involvement was also extensive, with poor visual outcomes seen in several participants.

These patients underwent surgical debridement and received antifungal therapy, including transcutaneous retrobulbar Amphotericin B.

Some of the factors predictive of poor orbital outcomes were duration of diabetes and glycated haemoglobin levels. In terms of mortality, the rate was 22.2 or nearly one in five patients.

“Timely intervention showed stabilization of the orbital disease and better outcomes in paediatric patients,” the researchers said. “[More studies] with larger sample sizes [are] warranted to better understand and address this serious condition.”