Fairfax A J, David V, Douce G
Departments of Respiratory Medicine, Ear, Nose & Throat Surgery and Pathology, Staffordshire General Hospital, Weston Road, Stafford ST16 3SA, UK.
Thorax. 1999 Sep;54(9):860-1. doi: 10.1136/thx.54.9.860.
The case history is presented of a 75 year old man with chronic asthma who was treated with inhaled fluticasone propionate in a daily dose of 2 mg using a Diskhaler. After three years of treatment he developed progressive hoarseness. Both vocal cords were colonised by Aspergillus fumigatus which formed a white slough on the surface. Biopsy specimens showed changes suggestive of laryngeal aspergillosis with an ulcerated epithelium, fibrinopurulent debris, and colonies of fungal hyphae. A slow recovery occurred after three months of treatment with topical amphotericin and with cessation of inhaled corticosteroids. Laryngoscopy is recommended if hoarseness occurs during treatment with fluticasone.
本文介绍了一名75岁慢性哮喘男性患者的病例。该患者使用准纳器，每日吸入2毫克丙酸氟替卡松进行治疗。治疗三年后，他出现了进行性声音嘶哑。双侧声带被烟曲霉定植，表面形成白色腐痂。活检标本显示有提示喉曲霉菌病的改变，包括上皮溃疡、纤维蛋白脓性碎屑和真菌菌丝菌落。经局部用两性霉素治疗及停用吸入性糖皮质激素三个月后，病情缓慢恢复。在用氟替卡松治疗期间若出现声音嘶哑，建议进行喉镜检查。
