Lee Ta-Jen, Huang Shiang-Fu, Huang Chi-Che, Chen Ying-Lin
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Chang Gung Med J. 2002 Jul;25(7):464-8.
Aspergillus fungus can be found worldwide and is the most common fungal infection of the paranasal sinuses. Despite this ubiquity, aspergillosis of the sphenoid sinus as an isolated disease in an otherwise healthy person is quite rare. We report two cases in this article: one was a 53-year-old woman who suffered from bloody postnasal drip for 2 weeks and the other a 61-year-old woman suffered from facial swelling for 2 months. Central dense areas, which are characteristic for Aspergillus sinus infection, were found on their computer tomographs. Both patients were managed by functional endoscopic sinus surgery without recurrence within the 6-month follow-up period. A survey of the reports in the literature indicated that the occurrence of isolated sphenoid sinus aspergillosis was predominantly in elderly females. Hormone changes which occur during this age might play a role in the pathogenesis of fungal infection. Treatment with an anti-fungal agent was not suggested for non-invasive aspergillosis. Instead, surgery played a major role in the treatment.
曲霉菌在世界各地均有发现,是鼻旁窦最常见的真菌感染。尽管其分布广泛,但蝶窦曲霉菌病作为一种在其他方面健康的个体中单独出现的疾病却相当罕见。我们在本文中报告两例病例:一例是一名53岁女性,出现鼻后滴漏带血症状两周;另一例是一名61岁女性,面部肿胀两个月。在她们的计算机断层扫描中发现了曲霉菌性鼻窦炎特有的中央致密区。两名患者均接受了功能性鼻内镜鼻窦手术治疗,在6个月的随访期内均无复发。对文献报道的一项调查表明,孤立性蝶窦曲霉菌病的发生主要见于老年女性。这个年龄段发生的激素变化可能在真菌感染的发病机制中起作用。对于非侵袭性曲霉菌病,不建议使用抗真菌药物治疗。相反,手术在治疗中起主要作用。