慢性肉芽肿性侵袭性真菌性鼻窦炎：一种不断发展的治疗方法。
Chronic granulomatous invasive fungal sinusitis: an evolving approach to management.
机构信息
Section of Rhinology, Sinus and Skull Base Surgery, Head & Neck Institute, Cleveland Clinic Foundation, Cleveland, OH.
出版信息
Int Forum Allergy Rhinol. 2014 Apr;4(4):280-3. doi: 10.1002/alr.21299. Epub 2014 Feb 7.
BACKGROUND
Chronic granulomatous invasive fungal sinusitis (CGIFS) is rare and a consensus on ideal management is lacking. We present an extensive case managed successfully with a conservative approach.
METHODS
Case report and literature review.
RESULTS
The patient presented with unilateral proptosis, papilledema, and headache. Imaging revealed an infiltrative process with extensive intracranial and intraorbital involvement. Biopsy showed fungal elements and granulomatous reaction consistent with CGIFS. The patient was managed with conservative surgery and long-term oral voriconazole.
CONCLUSION
This case supports a conservative surgical approach in some patients with extensive CGIFS. Oral voriconazole is effective and has significant advantages over more toxic agents administered intravenously.
背景
慢性肉芽肿性侵袭性真菌性鼻窦（CGIFS）罕见，其理想的治疗方法尚未达成共识。我们报告了一例经保守治疗成功的广泛病例。
方法
病例报告和文献回顾。
结果
患者表现为单侧眼球突出、视乳头水肿和头痛。影像学显示浸润性病变，伴有广泛的颅内和眶内受累。活检显示真菌成分和符合 CGIFS 的肉芽肿反应。患者接受了保守手术和长期口服伏立康唑治疗。
结论
本病例支持在某些广泛 CGIFS 患者中采用保守手术方法。口服伏立康唑有效，与静脉内给予更具毒性的药物相比具有显著优势。
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