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真菌性鼻-鼻窦炎发病机制分析：2例报告

Analysis of pathogenetic process of fungal rhinosinusitis: Report of two cases.

作者信息

Wang Lin-Lin, Chen Feng-Ji, Yang Long-Su, Li Jie-En

机构信息

Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530022, Guangxi Zhuang Autonomous Region, China.

出版信息

World J Clin Cases. 2020 Jan 26;8(2):451-463. doi: 10.12998/wjcc.v8.i2.451.

DOI:10.12998/wjcc.v8.i2.451
PMID:32047798
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7000939/
Abstract

BACKGROUND

Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal rhinosinusitis is higher than that in other provinces. However, its physiological mechanism is not yet clear. Not every patient colonized by fungi develops a fungal infection. To a large extent, the immune status of the patient determines the nature of fungal disease in the nasal passages. The pathologic process of progression from harmless fungal colonization to fungal rhinosinusitis is unclear and has not been reported.

CASE SUMMURY

We report two patients, one who developed fungal rhinosinusitis 1.5 years after surgery performed to treat an inverted papilloma, and the other with a history of hypertension and cerebral infarction. Both patients recovered from their surgeries. An average time of 2.5 years elapsed from the development of maxillary sinus cysts to the development of fungal rhinosinusitis.

CONCLUSION

According to these case reports, we speculate that the progression of fungal rhinosinusitis from harmless colonization to disease onset requires approximately one to three years and that the length of the process may be related to underlying diseases, surgical treatment, deficient autoimmune status, and abuse of hormone antibiotics and hormones. Additional data are needed to conduct relevant studies to appropriately prevent and treat fungal rhinosinusitis.

摘要

背景

真菌性鼻-鼻窦炎是鼻窦和鼻腔内由真菌引起的感染性和/或过敏性疾病。由于广西壮族自治区气候温暖湿润，真菌性鼻-鼻窦炎的发病率高于其他省份。然而，其生理机制尚不清楚。并非每个被真菌定植的患者都会发生真菌感染。在很大程度上，患者的免疫状态决定了鼻腔真菌病的性质。从无害的真菌定植发展到真菌性鼻-鼻窦炎的病理过程尚不清楚，也未见报道。

病例总结

我们报告了两名患者，一名在治疗内翻性乳头状瘤手术后1.5年发生真菌性鼻-鼻窦炎，另一名有高血压和脑梗死病史。两名患者手术后均康复。从上颌窦囊肿发展到真菌性鼻-鼻窦炎平均历时2.5年。

结论

根据这些病例报告，我们推测真菌性鼻-鼻窦炎从无害定植发展到发病大约需要1至3年，且这个过程的时长可能与基础疾病、手术治疗、自身免疫状态不足以及滥用激素抗生素和激素有关。需要更多数据来开展相关研究，以恰当预防和治疗真菌性鼻-鼻窦炎。

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