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Revised workflow practices in the management of acute invasive fungal sinusitis during the coronavirus disease 2019 pandemic

Published online by Cambridge University Press:  16 August 2022

R Kurien Open the ORCID record for R Kurien [Opens in a new window] ,
L Varghese Open the ORCID record for L Varghese [Opens in a new window] ,
L M Cherian ,
R Sundaresan ,
M John ,
M D Mammen ,
R R Inja ,
A Manesh ,
H Paul  and
P R Gurijala
...Show all authors
R Kurien*
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
L Varghese
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
L M Cherian
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
R Sundaresan
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
M John
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
M D Mammen
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
R R Inja
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
A Manesh
Affiliation:
Department of Infectious Diseases, Christian Medical College, Vellore, India
H Paul
Affiliation:
Department of Hospital Infection Control Committee, Christian Medical College, Vellore, India
P R Gurijala
Affiliation:
Department of Radiodiagnosis, Christian Medical College, Vellore, India
J S Michael
Affiliation:
Department of Microbiology, Christian Medical College, Vellore, India
M Thomas
Affiliation:
Department of Pathology, Christian Medical College, Vellore, India
K P P Abhilash
Affiliation:
Department of Emergency Medicine, Christian Medical College, Vellore, India
A M Varghese
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
V Rupa
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
*
Author for correspondence: Dr Regi Kurien, Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India – 632004 E-mail: [email protected]
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Abstract

Objective

To document changes in evaluation protocols for acute invasive fungal sinusitis during the coronavirus disease 2019 pandemic, and to analyse concordance between clinical and histopathological diagnoses based on new practice guidelines.

Methods

Protocols for the evaluation of patients with suspected acute invasive fungal sinusitis both prior and during the coronavirus disease 2019 period are described. A retrospective analysis of patients presenting with suspected acute invasive fungal sinusitis from 1 May to 30 June 2021 was conducted, with assessment of the concordance between clinical and final diagnoses.

Results

Among 171 patients with high clinical suspicion, 160 (93.6 per cent) had a final histopathological diagnosis of invasive fungal sinusitis, concordant with the clinical diagnosis, with sensitivity of 100 per cent, positive predictive value of 93.6 per cent and negative predictive value of 100 per cent.

Conclusion

The study highlights a valuable screening tool with good accuracy, involving emphasis on ‘red flag’ signs in high-risk populations. This could be valuable in situations demanding the avoidance of aerosol-generating procedures and in resource-limited settings facilitating early referral to higher level care centres.

Keywords

COVID-19Paranasal SinusesSinusitisMucormycosis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1314 - 1319
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr R Kurien takes responsibility for the integrity of the content of the paper

References

deShazo, RD, O'Brien, M, Chapin, K, Soto-Aguilar, M, Gardner, L, Swain, R. A new classification and diagnostic criteria for invasive fungal sinusitis. Arch Otolaryngol Head Neck Surg 1997;123:1181–8CrossRefGoogle ScholarPubMed
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020;5:536–44CrossRefGoogle Scholar
Raut, A, Huy, NT. Rising incidence of mucormycosis in patients with COVID-19: another challenge for India amidst the second wave? Lancet Respir Med 2021;9:e77CrossRefGoogle ScholarPubMed
Turner, JH, Soudry, E, Nayak, JV, Hwang, PH. Survival outcomes in acute invasive fungal sinusitis: a systematic review and quantitative synthesis of published evidence. Laryngoscope 2013;123:1112–18CrossRefGoogle ScholarPubMed
Indian Council of Medical Research. Evidence based advisory in the time of COVID-19 (screening, diagnosis & management of mucormycosis). In: https://www.icmr.gov.in/pdf/covid/techdoc/Mucormycosis_ADVISORY_FROM_ICMR_In_COVID19_time.pdf [9 September 2022]Google Scholar
Malleshappa, V, Rupa, V, Varghese, L, Kurien, R. Avoiding repeated surgery in patients with acute invasive fungal sinusitis. Eur Arch Otorhinolaryngol 2020;277:1667–74CrossRefGoogle ScholarPubMed
Chakrabarti, A, Das, A, Mandal, J, Shivaprakash, MR, George, VK, Tarai, B et al. The rising trend of invasive zygomycosis in patients with uncontrolled diabetes mellitus. Med Mycol 2006;44:335–42CrossRefGoogle ScholarPubMed
Song, G, Liang, G, Liu, W. Fungal co-infections associated with global COVID-19 pandemic: a clinical and diagnostic perspective from China. Mycopathologia 2020;185:599–606CrossRefGoogle ScholarPubMed
John, TM, Jacob, CN, Kontoyiannis, DP. When uncontrolled diabetes mellitus and severe COVID-19 converge: the perfect storm for mucormycosis. J Fungi (Basel) 2021;15:298CrossRefGoogle Scholar
Singh, AK, Singh, R, Joshi, SR, Misra, A. Mucormycosis in COVID-19: a systematic review of cases reported worldwide and in India. Diabetes Metab Syndr 2021;15:102146CrossRefGoogle ScholarPubMed
Fernandez, IJ, Crocetta, FM, Demattè, M, Farneti, P, Stanzani, M, Lewis, RE et al. Acute invasive fungal rhinosinusitis in immunocompromised patients: role of an early diagnosis. Otolaryngol Head Neck Surg 2018;159:386–93CrossRefGoogle ScholarPubMed
Ghadiali, MT, Deckard, NA, Farooq, U, Astor, F, Robinson, P, Casiano, RR. Frozen-section biopsy analysis for acute invasive fungal rhinosinusitis. Otolaryngol Head Neck Surg 2007;136:714–19CrossRefGoogle ScholarPubMed