Sinus CT for pediatric invasive fungal rhinosinusitis: 83% sensitivity, 97% specificity

Sinus CT had 83% sensitivity and 97% specificity (AUC 0.9) for acute invasive fungal rhinosinusitis in 106 children; 17.5% of cases were missed on CT, most often at the middle turbinate, so nasal endoscopy remains gold standard when suspicion persists.

• Among 106 at-risk children (mean age 9.4 years; leukemia most common risk factor), 40 had confirmed acute invasive fungal rhinosinusitis.
• Facial symptoms and duration of absolute neutrophil count below 500 and below 200 differed significantly by disease status (p<0.001, p=0.02, p=0.01).
• Retrospective design; a negative sinus CT still warrants nasal endoscopy when clinical concern remains.

Automated summary

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