Baumgart K, Motum P, Benson W
Clinical Immunology Research Centre, University of Sydney, NSW.
Pathology. 1990 Apr;22(2):111-4. doi: 10.3109/00313029009063791.
A 52-year-old man with chronic, profound pancytopenia associated with a four-year history of Waldenstrom's macroglobulinemia refractory to chemotherapy began to experience major epistaxes requiring hospital admission for control. A diagnosis of invasive Aspergillus was made on nasal mucosal biopsy. A regimen of bi-weekly intravenous and sixth-hourly topical amphotericin B drops with adjuvant rifampicin successfully eradicated local nasal pain as well as the epistaxis. Resolution of infection was documented by gallium scan. It is suggested that, in addition to the aggressive craniofacial mycoses already described, lower grade nasal mycoses occur. The roles of biopsy and gallium scan in immunocompromised hosts with epistaxis are discussed.
一名52岁男性，患有慢性、严重全血细胞减少症，伴有四年难治性化疗的华氏巨球蛋白血症病史，开始出现严重鼻出血，需要住院控制。经鼻黏膜活检诊断为侵袭性曲霉菌感染。采用每两周静脉注射一次及每六小时局部滴注一次两性霉素B并辅以利福平的治疗方案，成功消除了局部鼻痛和鼻出血症状。镓扫描证实感染已得到控制。研究表明，除了已描述的侵袭性颅面霉菌感染外，还存在低度鼻霉菌感染。本文讨论了活检和镓扫描在鼻出血免疫功能低下宿主中的作用。
