Gletsou Eleftheria, Ioannou Maria, Liakopoulos Vasileios, Tsiambas Evangelos, Ragos Vasileios, Stefanidis Ioannis
ENT Department, Medical School, University of Thessaly, Larissa, Greece.
J BUON. 2018 Dec;23(7):7-10.
Aspergillosis, which is saprophytic in nature, is known to cause massive destruction of paranasal sinuses in immunocompromised hosts, but in immunocompetent individuals invasive aspergillosis is rare. Diagnosis is posed from history, physical examination including anterior and posterior rhinoscopy, endoscopy of the nose and paranasal sinuses, radiological findings (CT and/or MRI), fungus cultures and histopathological examination. Non-specific presenting symptoms provide time for infection to extent from sinuses to vital surroundings such as bony, vascular and central nervous system structures, thereby increasing morbidity and mortality. Mass lesions involving the sinuses are initially misdiagnosed as tumors, inflammatory pseudotumors or pituitary adenomas. Therefore, diagnosis should be always confirmed by histopathology. Aspergillus sinusitis is a potentially fatal complication of immunosupression or of chemotherapy-induced leucopenia. Concerning patients with hematologic malignancies, it seems that its incidence is progressively increased. A combination of early diagnosis and application of specific antifungals provides the perfect management and prognosis in the corresponding patients. In the current special review, we present new data regarding the infection in patients with hematologic malignancies.
曲霉菌病本质上是腐生性的，已知会在免疫功能低下的宿主中导致鼻窦的大量破坏，但在免疫功能正常的个体中，侵袭性曲霉菌病很少见。诊断依据病史、体格检查（包括前后鼻镜检查）、鼻和鼻窦的内镜检查、影像学检查结果（CT和/或MRI）、真菌培养及组织病理学检查。非特异性的症状表现使得感染有时间从鼻窦蔓延至重要的周围结构，如骨骼、血管和中枢神经系统结构，从而增加发病率和死亡率。累及鼻窦的肿块病变最初常被误诊为肿瘤、炎性假瘤或垂体腺瘤。因此，诊断始终应通过组织病理学来证实。曲霉菌性鼻窦炎是免疫抑制或化疗引起的白细胞减少症的一种潜在致命并发症。对于血液系统恶性肿瘤患者，其发病率似乎在逐渐增加。早期诊断与应用特异性抗真菌药物相结合可为相应患者提供理想的治疗和预后。在本次专题综述中，我们展示了有关血液系统恶性肿瘤患者感染的新数据。
