Johnson C D, Brandes W
Department of Otorhinolaryngology and Orofacial Plastic Surgery, Botsford General Hospital, Farmington Hills, Mich.
J Am Osteopath Assoc. 1992 Aug;92(8):1047-51.
Fungal infections of the nose and paranasal sinuses are uncommon; Aspergillus is the most frequently isolated fungal pathogen. Invasive aspergillosis is commonly seen as an opportunistic infection in the immunocomprised, debilitated host. Whereas fulminant infection in the otherwise healthy patient is rare, in the immunocompetent host with persistent signs and symptoms of sinusitis despite appropriate medical management, aspergillosis should be considered. Treatment of paranasal sinus aspergillosis requires correction of immunologic deficits, if possible; aggressive surgical debridement to provide adequate drainage and aeration of the sinuses; and adjunctive antifungal chemotherapy. The authors present an unusual case of invasive aspergillosis of the paranasal sinuses in an immunocompetent host.
鼻腔及鼻窦的真菌感染并不常见；曲霉菌是最常分离出的真菌病原体。侵袭性曲霉菌病常见于免疫功能低下、身体虚弱的宿主，作为一种机会性感染。在原本健康的患者中暴发性感染很少见，但在免疫功能正常但尽管经过适当药物治疗仍有鼻窦炎持续症状和体征的宿主中，应考虑曲霉菌病。鼻旁窦曲霉菌病的治疗需要尽可能纠正免疫缺陷；积极进行外科清创以确保鼻窦有足够的引流和通气；以及辅助抗真菌化疗。作者报告了一例免疫功能正常宿主发生鼻旁窦侵袭性曲霉菌病的罕见病例。
