Invasive Fungal Sinusitis in the Pediatric Population: Systematic Review with Quantitative Synthesis of the Literature
Abstract Background Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. Methods We systematically reviewed EMBASE, Medline, TRIP...
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| Veröffentlicht in: | International journal of pediatric otorhinolaryngology 2016-11, Vol.90, p.231-235 |
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| container_title | International journal of pediatric otorhinolaryngology |
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| creator | Smith, Aaron, MD Thimmappa, Vikrum, MD Shepherd, Brandon, MD Ray, Meredith, PhD Sheyn, Anthony, MD Thompson, Jerome, MD, MBA |
| description | Abstract Background Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. Methods We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals |
| doi_str_mv | 10.1016/j.ijporl.2016.09.019 |
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In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. Methods We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals <18 years of age. Case series including 3 or more patients were included. Demographics, treatment and outcomes were analyzed using R Gui statistical software. Results Twelve studies met inclusion criteria (98 patients). There was male preponderance of 61% with median age of 11 years old. Majority of patients had underlying leukemia (47%). Aspergillus was the predominant organism (62%). Isolated nasal findings occurred in 15% of patients and nasal findings occurred in 49% overall. Absolute neutrophil count (ANC) of immunocompromised patients was below 600 in most patients (99%). Average and median length of neutropenia was 2 weeks. All patients were prescribed amphoterocin with 42% as single medicinal therapy. Surgery occurred in 84% of cases. The mortality rate was 48%. Univariate analysis identified presenting with facial pain as a negative predictor of overall mortality (OR 0.296, 95% CI: 0.104-0.843, p<0.05). Conclusion Mortality remains high in pediatric patients with IFS. An ANC of <600 occurred in the majority of immunocompromised patients at a duration of 2 weeks. Presenting with facial pain was a negative predictor of mortality. Many studies label this condition as invasive fungal sinusitis; however, approximately one seventh presented with only nasal findings and half overall had nasal involvement.</description><identifier>ISSN: 0165-5876</identifier><identifier>EISSN: 1872-8464</identifier><identifier>DOI: 10.1016/j.ijporl.2016.09.019</identifier><identifier>PMID: 27729140</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Amphotericin B - therapeutic use ; Anemia, Aplastic - immunology ; Antifungal Agents - therapeutic use ; Aspergillosis - immunology ; Aspergillosis - microbiology ; Aspergillosis - mortality ; Aspergillosis - therapy ; Aspergillus ; Burkitt Lymphoma - immunology ; Candidiasis, Invasive - immunology ; Candidiasis, Invasive - microbiology ; Candidiasis, Invasive - mortality ; Candidiasis, Invasive - therapy ; Child ; Facial Pain - etiology ; Female ; Fusariosis - immunology ; Fusariosis - microbiology ; Fusariosis - mortality ; Fusariosis - therapy ; Humans ; Immunocompromised ; Immunocompromised Host ; Invasive fungal sinusitis ; Leukemia - immunology ; Male ; Mucormycosis ; Mucormycosis - immunology ; Mucormycosis - microbiology ; Mucormycosis - mortality ; Mucormycosis - therapy ; Mycoses - immunology ; Mycoses - microbiology ; Mycoses - mortality ; Mycoses - therapy ; Neutropenia - immunology ; Otolaryngology ; Otorhinolaryngologic Surgical Procedures ; Pediatrics ; Prognosis ; Retrospective Studies ; Sinusitis - immunology ; Sinusitis - microbiology ; Sinusitis - mortality ; Sinusitis - therapy</subject><ispartof>International journal of pediatric otorhinolaryngology, 2016-11, Vol.90, p.231-235</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2016 Elsevier Ireland Ltd</rights><rights>Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-6939271c02e62c6edfc6133d12b77e2e0edb8e73e36df5668c9d2890d17d3fdf3</citedby><cites>FETCH-LOGICAL-c417t-6939271c02e62c6edfc6133d12b77e2e0edb8e73e36df5668c9d2890d17d3fdf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijporl.2016.09.019$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27729140$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, Aaron, MD</creatorcontrib><creatorcontrib>Thimmappa, Vikrum, MD</creatorcontrib><creatorcontrib>Shepherd, Brandon, MD</creatorcontrib><creatorcontrib>Ray, Meredith, PhD</creatorcontrib><creatorcontrib>Sheyn, Anthony, MD</creatorcontrib><creatorcontrib>Thompson, Jerome, MD, MBA</creatorcontrib><title>Invasive Fungal Sinusitis in the Pediatric Population: Systematic Review with Quantitative Synthesis of the Literature</title><title>International journal of pediatric otorhinolaryngology</title><addtitle>Int J Pediatr Otorhinolaryngol</addtitle><description>Abstract Background Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. Methods We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals <18 years of age. Case series including 3 or more patients were included. Demographics, treatment and outcomes were analyzed using R Gui statistical software. Results Twelve studies met inclusion criteria (98 patients). There was male preponderance of 61% with median age of 11 years old. Majority of patients had underlying leukemia (47%). Aspergillus was the predominant organism (62%). Isolated nasal findings occurred in 15% of patients and nasal findings occurred in 49% overall. Absolute neutrophil count (ANC) of immunocompromised patients was below 600 in most patients (99%). Average and median length of neutropenia was 2 weeks. All patients were prescribed amphoterocin with 42% as single medicinal therapy. Surgery occurred in 84% of cases. The mortality rate was 48%. Univariate analysis identified presenting with facial pain as a negative predictor of overall mortality (OR 0.296, 95% CI: 0.104-0.843, p<0.05). Conclusion Mortality remains high in pediatric patients with IFS. An ANC of <600 occurred in the majority of immunocompromised patients at a duration of 2 weeks. Presenting with facial pain was a negative predictor of mortality. Many studies label this condition as invasive fungal sinusitis; however, approximately one seventh presented with only nasal findings and half overall had nasal involvement.</description><subject>Amphotericin B - therapeutic use</subject><subject>Anemia, Aplastic - immunology</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Aspergillosis - immunology</subject><subject>Aspergillosis - microbiology</subject><subject>Aspergillosis - mortality</subject><subject>Aspergillosis - therapy</subject><subject>Aspergillus</subject><subject>Burkitt Lymphoma - immunology</subject><subject>Candidiasis, Invasive - immunology</subject><subject>Candidiasis, Invasive - microbiology</subject><subject>Candidiasis, Invasive - mortality</subject><subject>Candidiasis, Invasive - therapy</subject><subject>Child</subject><subject>Facial Pain - etiology</subject><subject>Female</subject><subject>Fusariosis - immunology</subject><subject>Fusariosis - microbiology</subject><subject>Fusariosis - mortality</subject><subject>Fusariosis - therapy</subject><subject>Humans</subject><subject>Immunocompromised</subject><subject>Immunocompromised Host</subject><subject>Invasive fungal sinusitis</subject><subject>Leukemia - immunology</subject><subject>Male</subject><subject>Mucormycosis</subject><subject>Mucormycosis - immunology</subject><subject>Mucormycosis - microbiology</subject><subject>Mucormycosis - mortality</subject><subject>Mucormycosis - therapy</subject><subject>Mycoses - immunology</subject><subject>Mycoses - microbiology</subject><subject>Mycoses - mortality</subject><subject>Mycoses - therapy</subject><subject>Neutropenia - immunology</subject><subject>Otolaryngology</subject><subject>Otorhinolaryngologic Surgical Procedures</subject><subject>Pediatrics</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sinusitis - immunology</subject><subject>Sinusitis - microbiology</subject><subject>Sinusitis - mortality</subject><subject>Sinusitis - therapy</subject><issn>0165-5876</issn><issn>1872-8464</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcFuEzEQhi0EoqHwBgj5yGW3HnvX3uWAhKoWKkWiEDhbjj1LHTbeYHtT5e1xmsKBCydr7H--kb8h5DWwGhjIi03tN7spjjUvVc36mkH_hCygU7zqGtk8JYvy0FZtp-QZeZHShjFQrG2fkzOuFO-hYQuyvwl7k_we6fUcfpiRrnyYk88-UR9ovkN6i86bHL2lt9NuHk32U3hHV4eUcVsKS7_i3uM9vff5jn6ZTcg-l_tCXB1CAaSCmoYH1NJnjCbPEV-SZ4MZE756PM_J9-urb5efquXnjzeXH5aVbUDlSvai5wos4yi5legGK0EIB3ytFHJk6NYdKoFCuqGVsrO9413PHCgnBjeIc_L2xN3F6deMKeutTxbH0QSc5qShE20DIICXaHOK2jilFHHQu-i3Jh40MH00rjf6ZFwfjWvW62K8tL15nDCvt-j-Nv1RXALvTwEs_yymok7WY7BFa0SbtZv8_yb8C7CjD96a8SceMG2mOYbiUINOXDO9Om79uHSQggnopfgN95SrOA</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Smith, Aaron, MD</creator><creator>Thimmappa, Vikrum, MD</creator><creator>Shepherd, Brandon, MD</creator><creator>Ray, Meredith, PhD</creator><creator>Sheyn, Anthony, MD</creator><creator>Thompson, Jerome, MD, MBA</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161101</creationdate><title>Invasive Fungal Sinusitis in the Pediatric Population: Systematic Review with Quantitative Synthesis of the Literature</title><author>Smith, Aaron, MD ; Thimmappa, Vikrum, MD ; Shepherd, Brandon, MD ; Ray, Meredith, PhD ; Sheyn, Anthony, MD ; Thompson, Jerome, MD, MBA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-6939271c02e62c6edfc6133d12b77e2e0edb8e73e36df5668c9d2890d17d3fdf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Amphotericin B - therapeutic use</topic><topic>Anemia, Aplastic - immunology</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Aspergillosis - immunology</topic><topic>Aspergillosis - microbiology</topic><topic>Aspergillosis - mortality</topic><topic>Aspergillosis - therapy</topic><topic>Aspergillus</topic><topic>Burkitt Lymphoma - immunology</topic><topic>Candidiasis, Invasive - immunology</topic><topic>Candidiasis, Invasive - microbiology</topic><topic>Candidiasis, Invasive - mortality</topic><topic>Candidiasis, Invasive - therapy</topic><topic>Child</topic><topic>Facial Pain - etiology</topic><topic>Female</topic><topic>Fusariosis - immunology</topic><topic>Fusariosis - microbiology</topic><topic>Fusariosis - mortality</topic><topic>Fusariosis - therapy</topic><topic>Humans</topic><topic>Immunocompromised</topic><topic>Immunocompromised Host</topic><topic>Invasive fungal sinusitis</topic><topic>Leukemia - immunology</topic><topic>Male</topic><topic>Mucormycosis</topic><topic>Mucormycosis - immunology</topic><topic>Mucormycosis - microbiology</topic><topic>Mucormycosis - mortality</topic><topic>Mucormycosis - therapy</topic><topic>Mycoses - immunology</topic><topic>Mycoses - microbiology</topic><topic>Mycoses - mortality</topic><topic>Mycoses - therapy</topic><topic>Neutropenia - immunology</topic><topic>Otolaryngology</topic><topic>Otorhinolaryngologic Surgical Procedures</topic><topic>Pediatrics</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sinusitis - immunology</topic><topic>Sinusitis - microbiology</topic><topic>Sinusitis - mortality</topic><topic>Sinusitis - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, Aaron, MD</creatorcontrib><creatorcontrib>Thimmappa, Vikrum, MD</creatorcontrib><creatorcontrib>Shepherd, Brandon, MD</creatorcontrib><creatorcontrib>Ray, Meredith, PhD</creatorcontrib><creatorcontrib>Sheyn, Anthony, MD</creatorcontrib><creatorcontrib>Thompson, Jerome, MD, MBA</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of pediatric otorhinolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, Aaron, MD</au><au>Thimmappa, Vikrum, MD</au><au>Shepherd, Brandon, MD</au><au>Ray, Meredith, PhD</au><au>Sheyn, Anthony, MD</au><au>Thompson, Jerome, MD, MBA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Invasive Fungal Sinusitis in the Pediatric Population: Systematic Review with Quantitative Synthesis of the Literature</atitle><jtitle>International journal of pediatric otorhinolaryngology</jtitle><addtitle>Int J Pediatr Otorhinolaryngol</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>90</volume><spage>231</spage><epage>235</epage><pages>231-235</pages><issn>0165-5876</issn><eissn>1872-8464</eissn><abstract>Abstract Background Invasive fungal sinusitis (IFS) represents an often fatal condition within the pediatric population. In an effort to characterize demographics, treatment modalities, and prognostic factors, we performed a systematic review. Methods We systematically reviewed EMBASE, Medline, TRIPdatabase, SCOPUS and the Cochrane database for invasive fungal nasal and sinus infections limited to individuals <18 years of age. Case series including 3 or more patients were included. Demographics, treatment and outcomes were analyzed using R Gui statistical software. Results Twelve studies met inclusion criteria (98 patients). There was male preponderance of 61% with median age of 11 years old. Majority of patients had underlying leukemia (47%). Aspergillus was the predominant organism (62%). Isolated nasal findings occurred in 15% of patients and nasal findings occurred in 49% overall. Absolute neutrophil count (ANC) of immunocompromised patients was below 600 in most patients (99%). Average and median length of neutropenia was 2 weeks. All patients were prescribed amphoterocin with 42% as single medicinal therapy. Surgery occurred in 84% of cases. The mortality rate was 48%. Univariate analysis identified presenting with facial pain as a negative predictor of overall mortality (OR 0.296, 95% CI: 0.104-0.843, p<0.05). Conclusion Mortality remains high in pediatric patients with IFS. An ANC of <600 occurred in the majority of immunocompromised patients at a duration of 2 weeks. Presenting with facial pain was a negative predictor of mortality. Many studies label this condition as invasive fungal sinusitis; however, approximately one seventh presented with only nasal findings and half overall had nasal involvement.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>27729140</pmid><doi>10.1016/j.ijporl.2016.09.019</doi><tpages>5</tpages></addata></record> |
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| ispartof | International journal of pediatric otorhinolaryngology, 2016-11, Vol.90, p.231-235 |
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| subjects | Amphotericin B - therapeutic use Anemia, Aplastic - immunology Antifungal Agents - therapeutic use Aspergillosis - immunology Aspergillosis - microbiology Aspergillosis - mortality Aspergillosis - therapy Aspergillus Burkitt Lymphoma - immunology Candidiasis, Invasive - immunology Candidiasis, Invasive - microbiology Candidiasis, Invasive - mortality Candidiasis, Invasive - therapy Child Facial Pain - etiology Female Fusariosis - immunology Fusariosis - microbiology Fusariosis - mortality Fusariosis - therapy Humans Immunocompromised Immunocompromised Host Invasive fungal sinusitis Leukemia - immunology Male Mucormycosis Mucormycosis - immunology Mucormycosis - microbiology Mucormycosis - mortality Mucormycosis - therapy Mycoses - immunology Mycoses - microbiology Mycoses - mortality Mycoses - therapy Neutropenia - immunology Otolaryngology Otorhinolaryngologic Surgical Procedures Pediatrics Prognosis Retrospective Studies Sinusitis - immunology Sinusitis - microbiology Sinusitis - mortality Sinusitis - therapy |
| title | Invasive Fungal Sinusitis in the Pediatric Population: Systematic Review with Quantitative Synthesis of the Literature |
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