Work

Paediatric Acute Invasive Fungal Sinusitis Outcomes Over a 13‐Year Period

Year: 2025

Type: article

Abstract: OBJECTIVES: To identify prognostic factors of paediatric acute invasive fungal sinusitis (AIFS) patients. DESIGN: Weighted cross-sectional analysis over 13-year period (2006-2019). SETTING: Public national hospitalisation database. PARTICIPANTS: Immunocompromised paediatric (age < 21 years) patients with sinonasal fungal infection who underwent sinonasal surgical treatment. MAIN OUTCOME MEASURES: Clinical characteristics (e.g., medical comorbidities, fungal species, age), mortality rate. STATISTICAL ANALYSIS: To compare mortality rates, the Fisher's exact test was used for individual conditions, each fungal species, and hospital treatment setting. The sample's median age (12 years) divided patients into younger and older groups. For two-sided tests, a p value of < 0.05 was considered significant. A Bonferroni correction was applied to evaluate fungal species and mortality, where a p value < 0.0167 was considered significant. RESULTS: A weighted total of 408 surgically treated AIFS patients were identified (median age 12 years). The most common immunocompromised comorbidities were neoplasms (75.7%) and hematologic disorders (71.2%). The most common fungal species were "other unspecified mycoses" as defined by ICD codes (53.8%) then mucormycoses (35%). The overall mortality rate was 16.1%. The only immunocompromised comorbidity associated with increased mortality was immunodeficiency disorders (25.3%; p = 0.023). Demographics associated with increased mortality were being male (12.3% vs. 3.9%; p = 0.004), but not older age (56.1% vs. 43.9%; p = 0.588). Patients with aspergillosis infections had increased mortality (26.2%; p = 0.003), but not other fungal species. CONCLUSION: In the largest national sample of paediatric AIFS patients, the overall mortality rate was 16.1%. Negative prognostic indicators included male sex, immunodeficiency disorder, and aspergillosis infections.

Source: Clinical Otolaryngology

DOI: 10.1111/coa.14310

Authors: Matthew James Wu, Marie‐Ange Munyemana, Lauren Roland

Institution: Washington University in St. Louis

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: National Institutes of Health, National Institute on Deafness and Other Communication Disorders, National Center for Advancing Translational Sciences