Miller David J.
Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Madison, WI 53706, USA. djm@ medicine.wisc.edu
Curr Infect Dis Rep. 2002 Jun;4(3):194-200. doi: 10.1007/s11908-002-0078-z.
Fungi are common inhabitants of the oral and nasal mucosa, and therefore the differentiation between colonization and pathogenicity in the setting of upper respiratory tract infection symptoms can be difficult. Fungal head and neck infections occur in both immunocompetent and immunocompromised persons, and patients with neutropenia, diabetes mellitus, corticosteroid use, and HIV infection are particularly susceptible to serious and potentially life-threatening infections. Invasive fungal head and neck infections generally require extensive surgical debridement and prolonged systemic antifungal therapy, and frequently carry a poor prognosis when the underlying immunosuppression cannot be corrected. In contrast, noninvasive fungal head and neck infections often respond to short courses of systemic or topical antifungal therapy, or require limited surgical debridement alone.
真菌是口腔和鼻粘膜的常见寄居菌,因此在上呼吸道感染症状的情况下,区分定植和致病性可能很困难。免疫功能正常和免疫功能低下的人都可能发生真菌性头颈部感染,而中性粒细胞减少症、糖尿病、使用皮质类固醇和感染艾滋病毒的患者尤其易患严重且可能危及生命的感染。侵袭性真菌性头颈部感染通常需要广泛的手术清创和长期的全身抗真菌治疗,并且当潜在的免疫抑制无法纠正时,预后往往很差。相比之下,非侵袭性真菌性头颈部感染通常对短期的全身或局部抗真菌治疗有反应,或者仅需要有限的手术清创。