2025 Poster Presentations
P039: HOW IMPORTANT IS COMPLETE SURGICAL RESECTION FOR SURVIVAL OF ACUTE INVASIVE FUNGAL SINUSITIS? CASE SERIES AND REVIEW OF THE LITERATURE
Chelsey Witsberger, MD; Mary Kress; Erin McKean, MD, MBA; University of Michigan
Objectives: Describe cases in which complete surgical resection was not required to survive acute invasive fungal sinusitis (AIFS). Compare patient demographics, disease extent, and treatment in these patients with those who underwent complete surgical resection of AIFS.
Study Design: Retrospective case series at a single tertiary care institution.
Results: Sixty-eight patients with acute invasive fungal sinusitis treated at our institution were identified. The cause of immune suppression in most cases included: bone marrow transplant (17), AML (14), type 2 diabetes mellitus (12), and chronic immunomodulator use (11). At the time of data analysis, 56% survived their infection despite incomplete or no surgical excision. Seven patients survived with medication management alone and all cases included treatment with IV antifungals.
Conclusion: Complete surgical resection is not required to survive acute invasive fungal sinusitis in all cases. The complex risk-benefit equation of radical surgical excision must be carefully considered for each individual patient by their team of experienced physicians.