Kusunoki Takeshi, Kase Kaori, Ikeda Katsuhisa
Department of Otorhinolaryngology, Juntendo University School of Medicine, Tokyo, Japan.
Clin Pract. 2011 Nov 29;1(4):e127. doi: 10.4081/cp.2011.e127. eCollection 2011 Sep 28.
Orbital apex syndrome is commonly been thought to have a poor prognosis. Many cases of this syndrome have been reported to be caused by paranasal sinus mycosis. We encountered a very rare case (60-year-old woman) of sinusitis with orbital apex syndrome due to Pseudomonas aeruginosa infection. She had received insulin and dialysis for diabtes and diabetic nephropathy, moreover anticoagulants after heart by-pass surgery. She underwent endoscopic sinus operation and was treated with antibiotics, but her loss of left vision did not improve. Recently, sinusitis cases due to Pseudomonas aeruginosa were reported to be a increasing. Therefore, we should consider the possibility of Pseudomonas aeruginosa as well as mycosis as infections of the sinus, especially inpatients who are immunocompromised body.
眶尖综合征通常被认为预后不佳。据报道,该综合征的许多病例由鼻窦真菌病引起。我们遇到了一例非常罕见的(60岁女性)因铜绿假单胞菌感染导致鼻窦炎伴眶尖综合征的病例。她因糖尿病和糖尿病肾病接受胰岛素治疗及透析,此外还在心脏搭桥手术后使用抗凝剂。她接受了鼻窦内窥镜手术并使用抗生素治疗,但左眼视力丧失并未改善。最近,据报道由铜绿假单胞菌引起的鼻窦炎病例在增加。因此,我们应考虑铜绿假单胞菌以及真菌病作为鼻窦感染的可能性,尤其是在免疫功能低下的住院患者中。