Sinusitis in the Bone Marrow Transplant Patient: Diagnosis and Management

Abstract

This study was undertaken to examine the frequency, morbidity, and management of sinus infections in patients undergoing bone marrow transplantation (BMT). Fifteen patients from February 1992 through February 1993 required intensive therapy for the management of paranasal sinus disease in the post-BMT period. Presenting symptoms included fever of unknown origin, sepsis, purulent nasal discharge, and ocular gaze abnormalities. Diagnosis was confirmed by computed tomographic (CT) scanning. Five patients required bilateral endoscopic sinus surgery. Preoperative preparation secondary to ongoing pancytopenia requiring platelet and fresh frozen plasma transfusions was undertaken. Fungal species and gram-negative and gram-positive organisms were all recovered from operative cultures. An algorithm for treatment of sinus problems in patients undergoing BMT is presented.