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侵袭性真菌性鼻-鼻窦炎的定义和管理:一项单中心回顾性研究。

Definition and management of invasive fungal rhinosinusitis: a single-centre retrospective study.

机构信息

Department of Otolaryngology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.

Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2021 Feb;41(1):43-50. doi: 10.14639/0392-100X-N0848.

Abstract

OBJECTIVES

The purpose of this study was to correlate acute invasive fungal rhinosinusitis (AIFRS) and chronic invasive fungal rhinosinusitis with underlying diseases, aetiological microorganisms, clinical symptoms, radiological findings, and surgical and medical treatment to determine the subset of patients who require more accurate diagnostic investigation and to prevent irreversible complications.

METHODS

This retrospective monocentric study included 17 patients who underwent endoscopic sinus surgery evaluated by paranasal computed tomography and magnetic resonance imaging. Age, sex and symptoms, and location of the invasive fungal infection and the causative fungus were analysed.

RESULTS

In total, 4 patients were affected by the AIFRS form, and 13 by the chronic form. Diabetes mellitus was reported in 41.17% of cases, and haematological diseases in 23.52%. The maxillary sinuses were involved in 47.05% of cases and sphenoidal sinuses in 52.94%; Aspergillus fumigatus was the fungus in 76.47% of cases, and Zygomycetes in 23.53%.

CONCLUSIONS

An understanding of the different types of fungal sinusitis and knowledge of their features play a crucial role in reaching prompt diagnosis and initiation of appropriate therapy, which is essential to avoid a protracted or fatal outcome.

摘要

目的

本研究旨在探讨急性侵袭性真菌性鼻-鼻窦炎(AIFRS)和慢性侵袭性真菌性鼻-鼻窦炎与基础疾病、病因微生物、临床症状、影像学表现以及手术和药物治疗的相关性,以确定需要更准确诊断性检查的患者亚组,并预防不可逆转的并发症。

方法

这是一项回顾性单中心研究,纳入了 17 名接受鼻内镜鼻窦手术的患者,这些患者均经过鼻窦计算机断层扫描和磁共振成像评估。分析了侵袭性真菌感染的位置、致病真菌以及患者的年龄、性别、症状。

结果

共有 4 名患者患有 AIFRS,13 名患者患有慢性侵袭性真菌性鼻-鼻窦炎。41.17%的病例报告有糖尿病,23.52%的病例报告有血液系统疾病。上颌窦受累占 47.05%,蝶窦受累占 52.94%;76.47%的病例为烟曲霉感染,23.53%的病例为接合菌感染。

结论

了解不同类型的真菌性鼻窦炎及其特征对于及时诊断和开始适当的治疗至关重要,这对于避免病程延长或致命结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0af/7982758/7f5c7214c15a/aoi-2021-01-43-g001.jpg

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