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Revised workflow practices in the management of acute invasive fungal sinusitis during the coronavirus disease 2019 pandemic

Published online by Cambridge University Press:  16 August 2022

R Kurien Open the ORCID record for R Kurien [Opens in a new window] ,
L Varghese Open the ORCID record for L Varghese [Opens in a new window] ,
L M Cherian ,
R Sundaresan ,
M John ,
M D Mammen ,
R R Inja ,
A Manesh ,
H Paul  and
P R Gurijala
...Show all authors
R Kurien*
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
L Varghese
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
L M Cherian
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
R Sundaresan
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
M John
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
M D Mammen
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
R R Inja
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
A Manesh
Affiliation:
Department of Infectious Diseases, Christian Medical College, Vellore, India
H Paul
Affiliation:
Department of Hospital Infection Control Committee, Christian Medical College, Vellore, India
P R Gurijala
Affiliation:
Department of Radiodiagnosis, Christian Medical College, Vellore, India
J S Michael
Affiliation:
Department of Microbiology, Christian Medical College, Vellore, India
M Thomas
Affiliation:
Department of Pathology, Christian Medical College, Vellore, India
K P P Abhilash
Affiliation:
Department of Emergency Medicine, Christian Medical College, Vellore, India
A M Varghese
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
V Rupa
Affiliation:
Department of ENT, Christian Medical College, Vellore, India
*
Author for correspondence: Dr Regi Kurien, Department of ENT, Christian Medical College, Vellore, Tamil Nadu, India – 632004 E-mail: [email protected]
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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

COVID-19Paranasal SinusesSinusitisMucormycosis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 12 , December 2022 , pp. 1314 - 1319
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr R Kurien takes responsibility for the integrity of the content of the paper

References

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