Lafont E, Aguilar C, Vironneau P, Kania R, Alanio A, Poirée S, Lortholary O, Lanternier F
Service maladies infectieuses et tropicales, hôpital Necker-Enfants-Malades, institut Imagine, université Paris Descartes, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75743 Paris, France.
EA REMES 7334 patient-reported outcomes, service d'ORL, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, université Paris Sorbonne Cité, 2, rue Ambroise-Paré, 75475 Paris, France.
Rev Mal Respir. 2017 Jun;34(6):672-692. doi: 10.1016/j.rmr.2016.09.004. Epub 2017 Jul 10.
Although sinusitis affects about 20 % of the population, fungal sinusitis is rare. Aspergillus sp. are most frequently implicated. Fungal sinusitis represents a wide spectrum of disorders, including acute or chronic and invasive or non-invasive forms. Invasive fungal sinusitis may develop in an immunocompromised or diabetic patient, whereas non-invasive fungal sinusitis should be considered in a chronic situation, resistant to antibiotics in immunocompetent patients. Allergic fungal sinusitis is related to hypersensitivity of the host to the fungus. The diagnosis of these infections requires radiological examination and endoscopy with mucosal biopsies examined histologically and mycologically in order to distinguish the different types of sinusitis. In the non-invasive forms, surgical treatment is essential, sometimes combined with antifungal and anti-inflammatory treatment. The invasive forms require antifungal treatment, combined with surgery in some forms, particularly mucormycosis.
尽管鼻窦炎影响约20%的人口，但真菌性鼻窦炎却很罕见。曲霉属最常与此相关。真菌性鼻窦炎代表了一系列广泛的病症，包括急性或慢性以及侵袭性或非侵袭性形式。侵袭性真菌性鼻窦炎可能在免疫功能低下或糖尿病患者中发生，而非侵袭性真菌性鼻窦炎应在慢性情况下予以考虑，在免疫功能正常的患者中对抗生素耐药。变应性真菌性鼻窦炎与宿主对真菌的超敏反应有关。这些感染的诊断需要进行放射学检查和内镜检查，并对黏膜活检组织进行组织学和真菌学检查，以区分不同类型的鼻窦炎。在非侵袭性形式中，手术治疗至关重要，有时还需联合抗真菌和抗炎治疗。侵袭性形式需要抗真菌治疗，某些形式（尤其是毛霉病）还需联合手术治疗。
