• Ly Xuan Quang, Truong Thanh Tam, Luong Huu Dang, Yen-Chun Chen, Shih-Han Hung, Tran Thanh Tai, Nguyen Le Vu Hoang, and Nguyen Van Thanh.
• Department of Otolaryngology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Viet Nam; Department of Otolaryngology, University Medical Center, Ho Chi Minh city, Viet Nam.
• J Formos Med Assoc. 2024 Mar 1; 123 (3): 357365357-365.

BackgroundAcute invasive fungal rhinosinusitis (AIFR) is a potentially lethal infection commonly found in immunocompromised patients. It is considered the most aggressive subtype of fungal sinusitis and can lead to severe morbidity and mortality. There was a significant increase in the incidence of AIFR in post-COVID-19 patients compared to AIFR cases before the COVID-19 pandemic. This study aimed to describe the clinical presentation of AIFR associated with COVID-19 illness.MethodsA retrospective study included 22 patients diagnosed with AIFR with a recent COVID-19 infection.ResultsThe most frequent disease associated with AIFR was diabetes mellitus (95.5%). The mycological analysis identified infection caused by Aspergillus species in 72.7% of patients. Along with stabilizing hemodynamic parameters and controlling any comorbidities, all patients in the present study underwent combined surgical debridement followed by antifungal medications. The overall survival rate was 72.7%. The chance of developing a fatal outcome was significantly higher if meningitis presented initially (odds ratio 35.63, p < 0.05).ConclusionThe presence of meningitis upon initial diagnosis is related to a significantly higher chance of developing a fatal outcome and should be considered, especially in AIFR patients previously treated for COVID-19 infections. Early diagnosis, early use of antifungal agents, aggressive surgical debridement, and control of comorbid conditions remain crucial in managing AIFR.Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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