Open AccessSurgical debridement for acute invasive fungal rhinosinusitis during the pre-engraftment phase of allogeneic hematopoietic stem cell transplantation
Author(s) -
Henry Cheng,
Lei Yuan,
Jingbo Wang
Publication year - 2018
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000012696
Subject(s) - medicine , contraindication , surgery , debridement (dental) , hematopoietic stem cell transplantation , transplantation , pathology , alternative medicine
Rationale: Surgical intervention may be not a contraindication for acute invasive fungal rhinosinusitis (AIFR) during the pre-engraftment period of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patient concerns: We present 2 cases involving patients with AIFR in the pre-engraftment phase of allo-HSCT. Diagnoses: Both patients received surgical debridement combined with systemic antifungal treatment. The biopsies identified the diagnosis of AIFR in these 2 cases. Outcomes: The 2 patients obtained normal hematopoiesis without recurrence of AIFR. Lesson: Our experience with these 2 cases suggests that prompt endoscopic surgical debridement is not an absolute contraindication for allo-HSCT recipients with AIFR during the pre-engraftment period. If permitted, urgent, radical, and aggressive but careful endoscopic debridement should be performed together with systemic antifungal treatment once AIFR has been diagnosed or suspected.