Chopra Hemant, Dua Kapil, Malhotra Vineeta, Gupta Rishi Pal, Puri Harpreet
Department of ENT, Ludhiana, Punjab, India.
Mycoses. 2006 Jan;49(1):30-6. doi: 10.1111/j.1439-0507.2005.01170.x.
Invasive fungal sinusitis of the paranasal sinuses in a healthy immunocompetent person is uncommon. Isolated involvement of any paranasal sinus, particularly sphenoid sinus is rare. In this study, five immunocompetent patients who had no nasal complaints but obscure symptoms of headache and orbital symptoms such as diplopia, retro-orbital pain and loss of vision were diagnosed to be having fulminant fungal sinusitis of the sphenoid sinus. Three patients had aspergillosis and two patients had mucormycosis. These patients initially presented to neurologists and ophthalmologists because they had no ENT complaints. The diagnosis was made on endoscopy, radiology and histopathology. They were treated aggressively according to the standard protocols. The purpose of this paper is to bring to light the changing clinical spectrum of invasive fungal sinusitis. It can occur in immunocompetent patients and in the form of isolated sphenoid sinus involvement.
在免疫功能正常的健康人中,鼻窦侵袭性真菌性鼻窦炎并不常见。任何鼻窦单独受累,尤其是蝶窦受累极为罕见。在本研究中,五名免疫功能正常的患者,无鼻部症状,但有头痛及复视、眶后疼痛和视力丧失等眼眶症状,被诊断为蝶窦暴发性真菌性鼻窦炎。三名患者患有曲霉菌病,两名患者患有毛霉菌病。这些患者最初因无耳鼻喉科症状而就诊于神经科医生和眼科医生。诊断依据内镜检查、影像学检查和组织病理学检查。他们根据标准方案积极接受治疗。本文旨在揭示侵袭性真菌性鼻窦炎不断变化的临床谱。它可发生于免疫功能正常的患者,且以孤立的蝶窦受累形式出现。