Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
BMJ Case Rep. 2021 Jan 27;14(1):e238721. doi: 10.1136/bcr-2020-238721.
Fungal infections involving the pituitary gland are rare and can be life threatening. A 75-year-old man with hypertension and diabetes mellitus presented with headache and hyponatraemia. Imaging study showed right upper lung mass, and mass resection showed aspergilloma without tissue invasion on histology. The patient developed visual impairment a few weeks later, and MRI of the brain revealed bilateral sphenoid sinusitis and pituitary invasion. The trans-sphenoidal biopsy confirmed invasive infection. His sphenoidal sinuses were endoscopically debrided, and he was treated with oral voriconazole. Pituitary aspergillosis should be considered in the differential diagnosis in patients with lung aspergilloma with headache and sinusitis. Prompt biopsy and antifungal treatment are important due to the high mortality rate of the infection.
累及垂体的真菌感染较为罕见，但可能危及生命。一名 75 岁男性，患有高血压和糖尿病，因头痛和低钠血症就诊。影像学检查显示右上肺肿块，肿块切除术后组织学检查显示为曲霉菌球，无组织侵犯。数周后患者出现视力障碍，脑部 MRI 显示双侧蝶窦炎和垂体侵犯。经蝶窦活检证实为侵袭性感染。他的蝶窦通过内镜清创，口服伏立康唑治疗。对于有头痛和鼻窦炎的肺曲霉菌球患者，应考虑垂体曲霉病作为鉴别诊断。由于感染的死亡率很高，因此及时进行活检和抗真菌治疗非常重要。
