Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients

Invasive fungal sinusitis can develop in immunosuppressed patients. A more complex problem is immunosuppressed patients who have undergone bone marrow transplantation. For a prolonged period, they are both neutropenic and thrombocytopenic. Survival in these patients is poor, and the role for extensi...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Otolaryngology-head and neck surgery 1997-06, Vol.116 (6), p.610-616
Hauptverfasser: KENNEDY, CYNTHIA A., ADAMS, GEORGE L., NEGLIA, JOSEPH P., GIEBINK, G.SCOTT
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 616
container_issue 6
container_start_page 610
container_title Otolaryngology-head and neck surgery
container_volume 116
creator KENNEDY, CYNTHIA A.
ADAMS, GEORGE L.
NEGLIA, JOSEPH P.
GIEBINK, G.SCOTT
description Invasive fungal sinusitis can develop in immunosuppressed patients. A more complex problem is immunosuppressed patients who have undergone bone marrow transplantation. For a prolonged period, they are both neutropenic and thrombocytopenic. Survival in these patients is poor, and the role for extensive surgical intervention for sinus disease has to be weighed against the risk and the potential that this is a systemic disease. Between January 1983 and June 1993, 29 bone marrow transplant recipients with documented invasive fungal infections of the sinuses and paranasal tissues required surgical intervention. This represents 1.7% of the total 1692 bone marrow transplants performed. There were 22 allogeneic, 6 autologous, and 3 unrelated donor transplants, with two patients receiving two separate grafts. Underlying diseases included 24 hematologic malignancies and 5 other disorders, including 1 aplastic anemia and 1 solid tumor. The mortality rate from the initial fungal infection was 62%. Twenty-seven percent resolved the initial infections but subsequently died of other causes. All patients received medical management, such as amphotericin, rifampin, and colony-stimulating factors, in addition to surgical intervention. Surgical management ranged from minimally invasive procedures to extensive resections including medial maxillectomies. Sixty-one percent of the patients who died of the initial infection had undergone extensive surgical procedures versus 55% of those who resolved the infection. Recovery of neutrophil counts was required to clear the infection but did not necessarily predict a good outcome because 50% of those who died of the infection had experienced neutrophil recovery. White blood cell counts at the time of surgery were not significantly different between the two groups. Prognosis was poor when cranial and orbital involvement and/or bony erosion occurred. (Otolaryngol Head Neck Surg 1997;116:610-6.)
doi_str_mv 10.1016/S0194-5998(97)70236-5
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79107903</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0194599897702365</els_id><sourcerecordid>1993991506</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5437-f00d0d827448411d928db3b23785260437477c70cfea2c9877328ab63cd6c323</originalsourceid><addsrcrecordid>eNqNkU9PFjEQxhujgVf0I2j2ZPCwOm13O-2BECUiJEQOcrbpdrukZv_R7vKGb-_ACxzV0zST3zOdeR7G3nH4xIGrzz-Bm6qsjdGHBj8iCKnK-gXbcDBYKs3xJds8I_vsdc6_AUApxD22L4zURhi-Yb_Oh9n5pZi6Iq_pOnrXF0sKbhnCSN2xmF1yo8vU7tbxmkocu-CXOI2ZnkUzjaEYXErTlnRuzHPvSDi7JdKA_Ia96lyfw9vHesCuTr9dnZyVF5ffz0--XJS-riSWHUALrRZYVbrivDVCt41shERdCwWEVIgewXfBCW80ohTaNUr6Vnkp5AH7sBs7p-lmDXmxQ8w-9LRLmNZs0XBAA5LAw7-C3BhpDK9BEVrvUJ-mnFPo7JwiXXpnOdj7COxDBPbeX2vQPkRga9K9f_xibYbQPquePCfgaAdsYx_u_m-qvTz78fVUKFEj6Y93-kCG3saQbPZktg9tTJSMbaf4jxX_AA3Np-Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1993991506</pqid></control><display><type>article</type><title>Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients</title><source>Wiley Journals</source><source>Alma/SFX Local Collection</source><creator>KENNEDY, CYNTHIA A. ; ADAMS, GEORGE L. ; NEGLIA, JOSEPH P. ; GIEBINK, G.SCOTT</creator><creatorcontrib>KENNEDY, CYNTHIA A. ; ADAMS, GEORGE L. ; NEGLIA, JOSEPH P. ; GIEBINK, G.SCOTT ; From the University of Minnesota</creatorcontrib><description>Invasive fungal sinusitis can develop in immunosuppressed patients. A more complex problem is immunosuppressed patients who have undergone bone marrow transplantation. For a prolonged period, they are both neutropenic and thrombocytopenic. Survival in these patients is poor, and the role for extensive surgical intervention for sinus disease has to be weighed against the risk and the potential that this is a systemic disease. Between January 1983 and June 1993, 29 bone marrow transplant recipients with documented invasive fungal infections of the sinuses and paranasal tissues required surgical intervention. This represents 1.7% of the total 1692 bone marrow transplants performed. There were 22 allogeneic, 6 autologous, and 3 unrelated donor transplants, with two patients receiving two separate grafts. Underlying diseases included 24 hematologic malignancies and 5 other disorders, including 1 aplastic anemia and 1 solid tumor. The mortality rate from the initial fungal infection was 62%. Twenty-seven percent resolved the initial infections but subsequently died of other causes. All patients received medical management, such as amphotericin, rifampin, and colony-stimulating factors, in addition to surgical intervention. Surgical management ranged from minimally invasive procedures to extensive resections including medial maxillectomies. Sixty-one percent of the patients who died of the initial infection had undergone extensive surgical procedures versus 55% of those who resolved the infection. Recovery of neutrophil counts was required to clear the infection but did not necessarily predict a good outcome because 50% of those who died of the infection had experienced neutrophil recovery. White blood cell counts at the time of surgery were not significantly different between the two groups. Prognosis was poor when cranial and orbital involvement and/or bony erosion occurred. (Otolaryngol Head Neck Surg 1997;116:610-6.)</description><identifier>ISSN: 0194-5998</identifier><identifier>EISSN: 1097-6817</identifier><identifier>DOI: 10.1016/S0194-5998(97)70236-5</identifier><identifier>PMID: 29389291</identifier><language>eng</language><publisher>Sage CA: Los Angeles, CA: Mosby, Inc</publisher><ispartof>Otolaryngology-head and neck surgery, 1997-06, Vol.116 (6), p.610-616</ispartof><rights>1997 American Academy of Otolaryngology–Head and Neck Surgery Foundation, Inc</rights><rights>1997 American Association of Otolaryngology‐Head and Neck Surgery Foundation (AAO‐HNSF)</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5437-f00d0d827448411d928db3b23785260437477c70cfea2c9877328ab63cd6c323</citedby><cites>FETCH-LOGICAL-c5437-f00d0d827448411d928db3b23785260437477c70cfea2c9877328ab63cd6c323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1016%2FS0194-5998%2897%2970236-5$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1016%2FS0194-5998%2897%2970236-5$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29389291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KENNEDY, CYNTHIA A.</creatorcontrib><creatorcontrib>ADAMS, GEORGE L.</creatorcontrib><creatorcontrib>NEGLIA, JOSEPH P.</creatorcontrib><creatorcontrib>GIEBINK, G.SCOTT</creatorcontrib><creatorcontrib>From the University of Minnesota</creatorcontrib><title>Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients</title><title>Otolaryngology-head and neck surgery</title><addtitle>Otolaryngol Head Neck Surg</addtitle><description>Invasive fungal sinusitis can develop in immunosuppressed patients. A more complex problem is immunosuppressed patients who have undergone bone marrow transplantation. For a prolonged period, they are both neutropenic and thrombocytopenic. Survival in these patients is poor, and the role for extensive surgical intervention for sinus disease has to be weighed against the risk and the potential that this is a systemic disease. Between January 1983 and June 1993, 29 bone marrow transplant recipients with documented invasive fungal infections of the sinuses and paranasal tissues required surgical intervention. This represents 1.7% of the total 1692 bone marrow transplants performed. There were 22 allogeneic, 6 autologous, and 3 unrelated donor transplants, with two patients receiving two separate grafts. Underlying diseases included 24 hematologic malignancies and 5 other disorders, including 1 aplastic anemia and 1 solid tumor. The mortality rate from the initial fungal infection was 62%. Twenty-seven percent resolved the initial infections but subsequently died of other causes. All patients received medical management, such as amphotericin, rifampin, and colony-stimulating factors, in addition to surgical intervention. Surgical management ranged from minimally invasive procedures to extensive resections including medial maxillectomies. Sixty-one percent of the patients who died of the initial infection had undergone extensive surgical procedures versus 55% of those who resolved the infection. Recovery of neutrophil counts was required to clear the infection but did not necessarily predict a good outcome because 50% of those who died of the infection had experienced neutrophil recovery. White blood cell counts at the time of surgery were not significantly different between the two groups. Prognosis was poor when cranial and orbital involvement and/or bony erosion occurred. (Otolaryngol Head Neck Surg 1997;116:610-6.)</description><issn>0194-5998</issn><issn>1097-6817</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><recordid>eNqNkU9PFjEQxhujgVf0I2j2ZPCwOm13O-2BECUiJEQOcrbpdrukZv_R7vKGb-_ACxzV0zST3zOdeR7G3nH4xIGrzz-Bm6qsjdGHBj8iCKnK-gXbcDBYKs3xJds8I_vsdc6_AUApxD22L4zURhi-Yb_Oh9n5pZi6Iq_pOnrXF0sKbhnCSN2xmF1yo8vU7tbxmkocu-CXOI2ZnkUzjaEYXErTlnRuzHPvSDi7JdKA_Ia96lyfw9vHesCuTr9dnZyVF5ffz0--XJS-riSWHUALrRZYVbrivDVCt41shERdCwWEVIgewXfBCW80ohTaNUr6Vnkp5AH7sBs7p-lmDXmxQ8w-9LRLmNZs0XBAA5LAw7-C3BhpDK9BEVrvUJ-mnFPo7JwiXXpnOdj7COxDBPbeX2vQPkRga9K9f_xibYbQPquePCfgaAdsYx_u_m-qvTz78fVUKFEj6Y93-kCG3saQbPZktg9tTJSMbaf4jxX_AA3Np-Q</recordid><startdate>199706</startdate><enddate>199706</enddate><creator>KENNEDY, CYNTHIA A.</creator><creator>ADAMS, GEORGE L.</creator><creator>NEGLIA, JOSEPH P.</creator><creator>GIEBINK, G.SCOTT</creator><general>Mosby, Inc</general><general>SAGE Publications</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>199706</creationdate><title>Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients</title><author>KENNEDY, CYNTHIA A. ; ADAMS, GEORGE L. ; NEGLIA, JOSEPH P. ; GIEBINK, G.SCOTT</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5437-f00d0d827448411d928db3b23785260437477c70cfea2c9877328ab63cd6c323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KENNEDY, CYNTHIA A.</creatorcontrib><creatorcontrib>ADAMS, GEORGE L.</creatorcontrib><creatorcontrib>NEGLIA, JOSEPH P.</creatorcontrib><creatorcontrib>GIEBINK, G.SCOTT</creatorcontrib><creatorcontrib>From the University of Minnesota</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Otolaryngology-head and neck surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KENNEDY, CYNTHIA A.</au><au>ADAMS, GEORGE L.</au><au>NEGLIA, JOSEPH P.</au><au>GIEBINK, G.SCOTT</au><aucorp>From the University of Minnesota</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients</atitle><jtitle>Otolaryngology-head and neck surgery</jtitle><addtitle>Otolaryngol Head Neck Surg</addtitle><date>1997-06</date><risdate>1997</risdate><volume>116</volume><issue>6</issue><spage>610</spage><epage>616</epage><pages>610-616</pages><issn>0194-5998</issn><eissn>1097-6817</eissn><abstract>Invasive fungal sinusitis can develop in immunosuppressed patients. A more complex problem is immunosuppressed patients who have undergone bone marrow transplantation. For a prolonged period, they are both neutropenic and thrombocytopenic. Survival in these patients is poor, and the role for extensive surgical intervention for sinus disease has to be weighed against the risk and the potential that this is a systemic disease. Between January 1983 and June 1993, 29 bone marrow transplant recipients with documented invasive fungal infections of the sinuses and paranasal tissues required surgical intervention. This represents 1.7% of the total 1692 bone marrow transplants performed. There were 22 allogeneic, 6 autologous, and 3 unrelated donor transplants, with two patients receiving two separate grafts. Underlying diseases included 24 hematologic malignancies and 5 other disorders, including 1 aplastic anemia and 1 solid tumor. The mortality rate from the initial fungal infection was 62%. Twenty-seven percent resolved the initial infections but subsequently died of other causes. All patients received medical management, such as amphotericin, rifampin, and colony-stimulating factors, in addition to surgical intervention. Surgical management ranged from minimally invasive procedures to extensive resections including medial maxillectomies. Sixty-one percent of the patients who died of the initial infection had undergone extensive surgical procedures versus 55% of those who resolved the infection. Recovery of neutrophil counts was required to clear the infection but did not necessarily predict a good outcome because 50% of those who died of the infection had experienced neutrophil recovery. White blood cell counts at the time of surgery were not significantly different between the two groups. Prognosis was poor when cranial and orbital involvement and/or bony erosion occurred. (Otolaryngol Head Neck Surg 1997;116:610-6.)</abstract><cop>Sage CA: Los Angeles, CA</cop><pub>Mosby, Inc</pub><pmid>29389291</pmid><doi>10.1016/S0194-5998(97)70236-5</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0194-5998
ispartof Otolaryngology-head and neck surgery, 1997-06, Vol.116 (6), p.610-616
issn 0194-5998
1097-6817
language eng
recordid cdi_proquest_miscellaneous_79107903
source Wiley Journals; Alma/SFX Local Collection
title Impact of surgical treatment on paranasal fungal infections in bone marrow transplant patients
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T12%3A05%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20surgical%20treatment%20on%20paranasal%20fungal%20infections%20in%20bone%20marrow%20transplant%20patients&rft.jtitle=Otolaryngology-head%20and%20neck%20surgery&rft.au=KENNEDY,%20CYNTHIA%20A.&rft.aucorp=From%20the%20University%20of%20Minnesota&rft.date=1997-06&rft.volume=116&rft.issue=6&rft.spage=610&rft.epage=616&rft.pages=610-616&rft.issn=0194-5998&rft.eissn=1097-6817&rft_id=info:doi/10.1016/S0194-5998(97)70236-5&rft_dat=%3Cproquest_cross%3E1993991506%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1993991506&rft_id=info:pmid/29389291&rft_els_id=S0194599897702365&rfr_iscdi=true