ENT and Facial Plastic Surgery, Children's of Minnesota, Minneapolis, MN, USA.
Department of Otolaryngology, University of Minnesota, Minneapolis, MN, USA.
Pediatr Transplant. 2021 Aug;25(5):e13853. doi: 10.1111/petr.13853. Epub 2021 Jan 23.
Invasive fungal disease of the head and neck is a potentially fatal infection most commonly seen in immunocompromised patients. Even in the setting of combined surgical and medical treatment, prognosis is generally poor. We report the first pediatric case of invasive fungal pharyngitis and summarize a review of the literature. A 10-year-old female patientwith aplastic anemia status post-bone marrow transplant and accompanying immunosuppression initially presented with a diagnosis of a peritonsillar abscess. Incision and drainage did not show purulence, but culture grew out Rhizopus species. Immediately after diagnosis, the patient was treated successfully with aggressive staged surgical debridement and antifungal medications and had an excellent functional outcome 2 years after initial presentation. Invasive fungal disease is most common in the sinonasal region, but alternative sites of disease must be considered in immunocompromised patients who present with atypical symptoms.
头颈部侵袭性真菌感染是一种潜在致命的感染，最常见于免疫功能低下的患者。即使在联合手术和药物治疗的情况下，预后通常也很差。我们报告了首例儿童侵袭性真菌性咽炎病例，并总结了文献复习。一名 10 岁女性患者，再生障碍性贫血，骨髓移植后伴免疫抑制，最初诊断为扁桃体周围脓肿。切开引流未见脓液，但培养出根霉属。诊断后，患者立即接受了积极的分阶段清创术和抗真菌药物治疗，初始表现 2 年后功能恢复良好。侵袭性真菌病最常见于鼻旁窦，但免疫功能低下患者出现不典型症状时，必须考虑其他部位的疾病。
