An Observational Study of Management of Invasive Fungal Sinusitis as Experienced in a Tertiary Care Institute

To study the various clinical presentations, microbiological and radiological proles in patients of invasive fungal sinusitis, to know about the underlying comorbidities or immunocompromised status and its relation to the disease. 2. To study the effect of timely surgery and long term antifungal therapy on prognosis of the patient. This is an observational prospective and retrospective study. Thirty adult patients diagnosed with invasive fungal sinusitis were studied. Our study also included patients who had past history of COVID 19 infection due to the ongoing pandemic. Diabetes mellitus was the most common underlying disease. Majority patients had a history of COVID 19 infection and had received intravenous steroids, as a part of the treatment for COVID-19 which led to deranged glucose levels, due to which these patients had increased risk of developing Invasive Fungal Sinusitis. Radiological imaging was done, that included CT and MRI. Patients were posted for debridement and the samples were sent for microbiological and histopathological examination. On KOH mount, aseptate hyphae were seen and on fungal culture most commonly isolated species was mucor and histoplathological examination was suggestive of Acute invasive fungal sinusitis. Treatment protocol was administration of Injection Amphotericin B with endoscopic sinus surgery with debridement along with maxillectomy, orbital exenteration (depending on the extension) along with or without concurrent oral posaconazole. Majority of the patients improved clinically. Acute Invasive Fungal Sinusitis is a condition seen in patients with Diabetes mellitus and or other immunocompromised condition. COVID 19 infection is probably a predisposing factor due to covid induced hyperglycemia and use of steroids. Imaging plays a key role in early diagnosis and mapping of the disease extent. Timely initiation of antifungal therapy and agressive surgical management and reversal of the immunocompromised status can signicantly improve the clinical outcome.