Yagi H I, Gumaa S A, Shumo A I, Abdalla N, Gadir A A
Department of Otolaryngology, Faculty of Medicine, University of Khartoum, Sudan.
J Otolaryngol. 1999 Apr;28(2):90-4.
The objective of this study was a prospective analysis of the clinical features, pathology, diagnosis, and treatment of patients treated between 1993 and 1996 for nasosinus aspergillosis in the Sudan.
Clinical examinations and laboratory tests for serologic, mycologic, and histologic analysis were conducted on all patients, as were radiologic and computerized tomographic studies when external swelling of any of the paranasal sinuses was evident.
The age group 11 to 50 years were predominantly affected, with a peak in those aged 21 to 30 years. Females were affected more often than were males. The clinical features were mainly nasal polyposis, external swelling of the ethmoid sinus medial to the inner canthus, or maxillary cheek swelling and/or proptosis. In the paranasal sinuses, the ethmoids were the most frequently affected. Intracranial extension of the disease occurred in two patients. Serologic examinations and mycological cultures showed more incidence of positive results than did histopathology. Aspergillus flavus was grown in all the positive mycologic cultures except one, where Aspergillus niger was grown. The treatment was mainly surgical, supplemented by an antifungal drug (itraconazole). The incidence of recurrence was 9.3%, and it was noticed that the recurrence occurred in those patients who were not taking their medicines regularly.
Nasosinus aspergillosis is a common disease in Sudan. Nasal polyposis is the commonest mode of clinical presentation. Serology and mycologic cultures are quite helpful in the diagnosis. Surgical and medical treatment are complementary of each other.
本研究的目的是对1993年至1996年在苏丹接受治疗的鼻窦曲霉菌病患者的临床特征、病理学、诊断和治疗进行前瞻性分析。
对所有患者进行了血清学、真菌学和组织学分析的临床检查及实验室检测，当任何鼻窦出现明显外部肿胀时，还进行了放射学和计算机断层扫描研究。
11至50岁年龄组受影响最为严重，21至30岁年龄段达到高峰。女性比男性更常受到影响。临床特征主要为鼻息肉、内眦内侧筛窦外部肿胀、上颌脸颊肿胀和/或眼球突出。在鼻窦中，筛窦最常受累。两名患者出现疾病颅内扩展。血清学检查和真菌培养显示阳性结果的发生率高于组织病理学检查。除1例培养出黑曲霉外，所有阳性真菌培养均培养出黄曲霉。治疗主要为手术，辅以抗真菌药物（伊曲康唑）。复发率为9.3%，且发现复发发生在未规律服药的患者中。
鼻窦曲霉菌病在苏丹是一种常见疾病。鼻息肉是最常见的临床表现形式。血清学和真菌培养对诊断非常有帮助。手术和药物治疗相辅相成。
