真菌性鼻窦炎:报告两例无痛型真菌常侵袭,向上治疗与护理。

M Pénicaud, J Michel, P Belenotti, S Ranque, A Varoquaux, A Giovanni, P Dessi
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引用次数: 0

摘要

目的:与曲霉菌性鼻窦炎不同,毛霉病引起的鼻窦感染通常是侵袭性的,具有致死性。我们报告两例单侧单纯诊断为毛霉菌病的慢性鼻窦炎,经病理或真菌学证实,并讨论治疗策略。病例1)一例免疫功能正常的右侧慢性蝶窦炎患者在本院接受了鼻内手术。在手术真菌学标本上发现了米根霉。患者术后未接受辅助药物治疗,因为没有侵入性的临床或放射标准,也没有组织病理学证实。进行了临床、放射学和真菌学随访。病例2)一例慢性上颌窦炎患者在我院行鼻内手术。组织学分析发现纤维有利于毛霉病,无血管栓塞。我们决定与国家真菌学参考中心达成一致,不进行医学治疗。结论:两例患者随访3年以上,倾向于证实这一集体决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Fungal sinusitis: report of two cases of indolent form of fungus usually invasive, up treatment and care].

Objectives: Unlike Aspergillus sinusitis, sinus infections by mucormycosis are often invasive and have a lethal potential. We report two cases of chronic sinusitis with unilateral uncomplicated diagnosis of mucormycosis confirmed by pathology or mycology and discuss the therapeutic strategy.

Presentation: Case 1) An immunocompetent patient with a right chronically sphenoid sinusitis uncomplicated underwent endonasal surgery in our institution. Rhizopus Oryzae was found on the surgical mycological specimen. The patient received no adjuvant medical therapy after surgery, because there were no invasive clinical or radiological criteria and no histopathological confirmation. Clinical, radiological and mycological follow-up was done. Case 2) A patient with a chronic maxillary sinusitis underwent endonasal surgery in our institution. Histological analysis found filaments in favor of mucormycosis without vascular emboli. We decided in agreement with the national reference center for mycology not to treat medically.

Conclusion: A follow up of more than 3 years for both cases tends to confirm this collective decision.

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