Department of ENT, Christian Medical College, Vellore, India.
Department of Infectious Diseases, Christian Medical College, Vellore, India.
J Laryngol Otol. 2022 Dec;136(12):1314-1319. doi: 10.1017/S0022215122001888. Epub 2022 Aug 16.
To document changes in evaluation protocols for acute invasive fungal sinusitis during the coronavirus disease 2019 pandemic, and to analyse concordance between clinical and histopathological diagnoses based on new practice guidelines.
Protocols for the evaluation of patients with suspected acute invasive fungal sinusitis both prior and during the coronavirus disease 2019 period are described. A retrospective analysis of patients presenting with suspected acute invasive fungal sinusitis from 1 May to 30 June 2021 was conducted, with assessment of the concordance between clinical and final diagnoses.
Among 171 patients with high clinical suspicion, 160 (93.6 per cent) had a final histopathological diagnosis of invasive fungal sinusitis, concordant with the clinical diagnosis, with sensitivity of 100 per cent, positive predictive value of 93.6 per cent and negative predictive value of 100 per cent.
The study highlights a valuable screening tool with good accuracy, involving emphasis on 'red flag' signs in high-risk populations. This could be valuable in situations demanding the avoidance of aerosol-generating procedures and in resource-limited settings facilitating early referral to higher level care centres.
记录 2019 年冠状病毒病大流行期间急性侵袭性真菌性鼻窦炎评估方案的变化，并根据新的实践指南分析临床和组织病理学诊断之间的一致性。
描述了在冠状病毒病 2019 年之前和期间评估疑似急性侵袭性真菌性鼻窦炎患者的方案。对 2021 年 5 月 1 日至 6 月 30 日期间出现疑似急性侵袭性真菌性鼻窦炎的患者进行了回顾性分析，评估了临床和最终诊断之间的一致性。
在 171 例高度疑似临床的患者中，160 例（93.6%）的最终组织病理学诊断为侵袭性真菌性鼻窦炎，与临床诊断一致，其灵敏度为 100%，阳性预测值为 93.6%，阴性预测值为 100%。
该研究强调了一种具有良好准确性的有价值的筛选工具，强调了高危人群中的“红旗”征象。在需要避免产生气溶胶的操作的情况下，以及在资源有限的情况下促进向更高水平的护理中心及早转诊，这可能是有价值的。
