Contemporary Management of Pediatric Invasive Fungal Rhinosinusitis

Pediatric invasive fungal sinusitis is a devasting disease that classically affects pediatric hematology/oncology patients. It necessitates early intervention and is plagued by a high mortality rate. This work investigates current evidence behind the diagnosis, management, and outcomes for this particular disease in addition to areas of emerging treatment paradigms.

There is a paucity of concrete clinical guidelines for children regarding the diagnosis and treatment of pediatric invasive fungal rhinosinusitis given its relative rarity. Critical concepts of utmost importance include a high index of suspicion with a low threshold to obtain radiographic imaging and laboratory studies to clinch the diagnosis. Aggressive surgical management remains the cornerstone of treatment in conjunction with antifungal therapy. Recent breakthroughs include drug delivery methods, utilization of cell-free DNA (deoxyribunocleic acid) as a novel diagnostic tool, and emerging antimicrobials.

New treatment paradigms for pediatric invasive fungal sinusitis include a shift towards early diagnosis and targeted antifungal therapy. There is an urgent need for the development of standardized clinical guidelines regarding the diagnosis, treatment, and long-term surveillance of pediatric patients with invasive fungal rhinosinusitis.