Nowak Katarzyna, Szyfter Witold
Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu.
Otolaryngol Pol. 2008;62(6):716-21. doi: 10.1016/S0030-6657(08)70346-9.
Fungal infections of the ear and paranasal sinus, are recognised quite rarely, but they make sometimes, for many reasons, very important diagnostic-therapy issue. Cantagion may developes near every paranasal sinus. Facilities to invasion give every states, which weaken general and punctual immunity (like immunosupression, chemo-sterydotherapy, blood disease, pregnancy and HIV). After penetrated organism, course of infections, in case of type of patogens, trim of the patient and localization, can have without symptoms, sharp, chronic or fulminant shape. The hardest course with the highest mortality occur in the cases of mucormycosis and aspergillosis. Actually curiosity occur cases of fungal infections, since this times consider to be unpathogenic for humans. For treatment of sinus mycosis in majority chirurgical treatment is required. In addition or the sake of morphological differentiation fungal, in their developing cycle, treatment mycosis recommends serious difficulty, extra factor, which impeds therapy, is a must of prolongely antifungal treatment and repeated (to total elimination) remove hyphae from sinus, which stay sometimes even for week. Progress of the mycotic infections in paranasal sinus, remain bacterial infections and is often reason of bad diagnosis and incorrect treatment.
耳部和鼻窦的真菌感染很少被认识到，但由于多种原因，它们有时会成为非常重要的诊断治疗问题。感染可能发生在每个鼻窦附近。侵袭的条件是任何削弱全身和局部免疫力的状态（如免疫抑制、化疗、血液疾病、怀孕和艾滋病毒感染）。病原体侵入机体后，根据病原体类型、患者情况和感染部位，感染过程可能无症状、急性、慢性或暴发性。毛霉菌病和曲霉菌病的病程最严重，死亡率最高。实际上，真菌感染的病例令人好奇，因为这些真菌在过去被认为对人类无致病性。对于鼻窦霉菌病的治疗，大多数情况下需要手术治疗。此外，为了对真菌进行形态学鉴别，在其生长周期中，治疗霉菌病存在严重困难，阻碍治疗的另一个因素是必须进行长期抗真菌治疗，并反复（直至完全清除）从鼻窦中清除菌丝，这些菌丝有时甚至会残留数周。鼻窦霉菌感染的进展与细菌感染并存，这常常是诊断错误和治疗不当的原因。
