CÁC ĐẶC ĐIỂM LÂM SÀNG ĐẶC TRƯNG CỦA NGƯỜI BỆNH VIÊM MŨI XOANG DO NẤM XÂM LẤN CẤP TÍNH TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC TP. HỒ CHÍ MINH

Abstract

Objective: The study aimed to investigate the clinical characteristics of patients with Acute Invasive Fungal Rhinosinusitis (AIFRS) at the University Medical Center Ho Chi Minh City, focusing on clinical features, underlying conditions, causative pathogens, and treatment methods. Methods: A retrospective descriptive study of 50 AIFRS patients (2021–2023) assessed symptoms, endoscopic findings, imaging (CT/MRI), surgical methods, and antifungal therapy. Data were analyzed using SPSS 22. Results: 50 patients (mean age 60.76 ± 13.82, nearly equal gender distribution) with acute invasive fungal rhinosinusitis was conducted. Common comorbidities included diabetes (94%) and COVID-19 (34%). Mucormycosis (62%) was more prevalent than Aspergillus (38%). Key symptoms: mucosal necrosis (96%), headache (90%), facial pain (68%), and vision loss (44%). Severe complications included orbital invasion (36%), intracranial extension (24%), and meningitis (40%). Primary treatments were sinonasal debridement (100%) and endoscopic surgery (86%). Voriconazole (82%) was the most used antifungal. Mucormycosis was significantly associated with diabetes, palatal ulcers (58.1%), and maxillary sinus involvement (67.7%) compared to Aspergillus (p<0.05). Conclusion: This study show AIFRS prevalent in diabetics (94%), especially Mucormycosis (100%). Common symptoms: headache, mucosal necrosis. Mucormycosis caused more palatal ulcers and maxillary sinus involvement. COVID-19 increased mortality risk 8.83-fold, emphasizing early diagnosis and aggressive treatment in diabetic and COVID-19 patients.