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[鼻窦毛霉病]

[Mucormycosis in paranasal sinuses].

作者信息

Ishida M, Noiri T, Taya N, Kamihata T, Yoshihara W, Kanno I, Ogino S

出版信息

Nihon Jibiinkoka Gakkai Kaiho. 1989 Jan;92(1):21-7. doi: 10.3950/jibiinkoka.92.21.

Abstract

Paranasal sinus mucormycosis is a rare and often fatal condition that occasionally occurs in patients with debilitating disease. Five mucormycosis cases with paranasal sinus involvement are reported. Two also complicated diabetes mellitus. These diabetic patients rapidly developed meningitis after the onset of symptoms. One case was soon operated upon and necrotic masses with fungus were excised. Despite i.v. amphotericin B administration, two patients lost their consciousness in a few days, relapsed into coma and died. In these cases, the infection originated from the ethmoidal sinus and directly spread towards the orbit and brain. The remaining three cases with mucormycosis had operations after the initial diagnosis of sinusitis. All of the three patients are alive and well. The combination of an excisional operation and antifungal therapy resulted in favorable response. High resolution CT scanning is valuable both in planning treatment and monitoring the response to therapy.

摘要

鼻窦毛霉菌病是一种罕见且通常致命的疾病,偶尔发生于患有衰弱性疾病的患者。本文报告了5例累及鼻窦的毛霉菌病病例。其中2例还合并糖尿病。这些糖尿病患者在症状出现后迅速发展为脑膜炎。1例患者很快接受了手术,切除了带有真菌的坏死肿块。尽管静脉注射了两性霉素B,但仍有2例患者在数天内失去意识,陷入昏迷并死亡。在这些病例中,感染起源于筛窦,并直接向眼眶和脑部扩散。其余3例毛霉菌病患者在初步诊断为鼻窦炎后接受了手术。所有3例患者均存活且状况良好。手术切除与抗真菌治疗相结合产生了良好的效果。高分辨率CT扫描在规划治疗和监测治疗反应方面均具有重要价值。

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