Paludetti G, Rosignoli M, Ferri E, Cesari M R, Morace G, Fantoni M, Galli J
Istituto di Clinica Otorinolaringoiatrica, Università Cattolica del Sacro Cuore, Policlinico Universitario A. Gemelli, Roma.
Acta Otorhinolaryngol Ital. 1992 Nov-Dec;12(6):581-91.
The authors describe a case of invasive nasosinusal aspergillosis in an immunocompetent patient. After a careful bibliographic review, they emphasize that in the present case the diagnosis was made by means of fungal culture as the clinical picture, imaging techniques and histopathological findings were aspecific. The pathogenetic agent resulted Aspergillus tamarii which belongs to the Aspergillus flavus group and is one of the most unusual agents in literature. The treatment of choice, in the invasive form, is surgery that should be as radical as possible followed by a medical therapy. In the present case, after two-phase radical surgery on all the paranasal sinuses, medical treatment with traconazole was employed with excellent local results at a follow-up of one year.
作者描述了一例免疫功能正常患者的侵袭性鼻-鼻窦曲霉菌病。在仔细查阅文献后,他们强调,在本病例中,由于临床表现、影像学检查和组织病理学结果均不具有特异性,因此通过真菌培养做出了诊断。致病病原体为塔宾曲霉,它属于黄曲霉群,是文献中最不常见的病原体之一。侵袭性曲霉菌病的首选治疗方法是尽可能彻底的手术,术后进行药物治疗。在本病例中,对所有鼻窦进行了两期根治性手术后,采用了曲康唑进行药物治疗,随访一年时局部效果良好。