{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:47:20Z","timestamp":1789094840317,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,2,16]],"date-time":"2016-02-16T00:00:00Z","timestamp":1455580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To describe a 15\u2010year single\u2010institution experience of 41 cases of acute invasive fungal sinusitis (AIFRS), identify clinical indicators predictive of AIFRS, and discuss our approach to these high\u2010acuity patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral center; The Pennsylvania State University Hershey Medical Center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A retrospective review was performed for AIFRS consultations between September 1999 and March 2014. Variables reviewed included underlying condition, presenting symptoms, absolute neutrophil count, disease extent on examination, radiographic findings, medical treatment, biopsy results, surgical treatment, and outcomes. Univariate analysis was performed to determine variables significantly associated with AIFRS. Outcome measures were assessed and patient assessment algorithm developed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 131 patients evaluated, 41 were diagnosed with AIFRS; 92.7% had an underlying hematologic malignancy. Disease predictive variables included absolute neutrophil count &lt;500\/\u03bcL (<jats:italic>P<\/jats:italic> &lt;. 0001; sensitivity = 78%), mucosal abnormalities of middle turbinate (<jats:italic>P<\/jats:italic> &lt;. 0001; specificity = 88%) and septum (<jats:italic>P<\/jats:italic> &lt;. 0001; specificity = 97%), and specifically, necrosis of the middle turbinate (<jats:italic>P<\/jats:italic> &lt;. 0001; specificity = 97%). Twenty\u2010five AIFRS patients (61%) survived until discharge; 25% (n = 10) expired secondary to AIFRS infection explicitly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This series represents one of the largest single\u2010institution experiences of AIFRS published to date. Timely diagnosis is necessary to improve patient outcomes and limit morbidity. Maintaining a high index of suspicion in at\u2010risk patient populations, followed by prompt evaluation and management, is crucial in suspected AIFRS. The presence or absence of certain findings appear to correlate with biopsy results and may aid in appropriately gauging clinical suspicion for the presence of AIFRS.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815627786","type":"journal-article","created":{"date-parts":[[2016,2,16]],"date-time":"2016-02-16T21:59:44Z","timestamp":1455659984000},"page":"759-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Acute Invasive Fungal Rhinosinusitis"],"prefix":"10.1002","volume":"154","author":[{"given":"Sakeena J.","family":"Payne","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery The Pennsylvania State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Mitzner","sequence":"additional","affiliation":[{"name":"ENT and Allergy Associates LLP Lake Success New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Kunchala","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery The Pennsylvania State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Roland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Washington University in St Louis St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnathan D.","family":"McGinn","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery The Pennsylvania State Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-250"},{"issue":"3","key":"e_1_2_9_3_1","first-page":"203","article-title":"Invasive fungal sinusitis in patients undergoing bone marrow transplantation","volume":"12","author":"Drakos PE","year":"1993","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240401800202"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23978"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20014"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2011.08.005"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4115"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900110031005"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20520"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23912"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215111001289"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181dde8fc"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4298"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815627786","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599815627786","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815627786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:38:26Z","timestamp":1760967506000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599815627786"}},"subtitle":["A 15\u2010Year Experience with 41\u00a0Patients"],"short-title":[],"issued":{"date-parts":[[2016,2,16]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1177\/0194599815627786"],"URL":"https:\/\/doi.org\/10.1177\/0194599815627786","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,16]]},"assertion":[{"value":"2015-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-12-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}