Publication:

Invasive fungal sinusitis-analysis of management scenario

Background The objective of the study was to analyse the outcomes after therapeutic treatment of invasive fungal sinusitis.

Methods A cross-sectional study consisting of 30 patients from January 2015-December 2005 in Jawaharlal Nehru medical college, department of ENT, Belagavi. Antifungal drugs were used like Amphotericin B-both non-liposomal & liposomal variety, and analysis of various parameters like its duration, efficacy and dosage was done in determining the prognosis.

Results The liposomal type of amphotericin B (AmBisone), which was used in 23 patients (76.6%) had a response rate of 65% and failure rate of 26%, with minimum dose of 50 mg/day to maximum dose of 200 mg/day. The maximum number of days used was for 46 days in 18 cases, which showed the effectiveness in controlling the infection. Amphotericin B deoxycholate (Fungizone) was used in 6 patients (20%) with response rate of 50% and failure rate of 33.3% and maximum dose given was 25 mg/day keeping a track of the renal profile. The total duration of treatment with Fungizone was for 14 days.

Conclusions Along with surgical intervention, we were able to combat this fatal disease in 56% patients which was the overall survival rate and liposomal variety was preferred as majority of the patients had deranged renal parameters on presentation. But certain constraints like non-affordability by poor patients, cost-effectiveness on long term usage, were there. So further studies about the availability of more safer and affordable antifungals should be done.