Babu S, Samuel P
Royal Infirmary, Sunderland.
J Laryngol Otol. 1988 Jul;102(7):592-4. doi: 10.1017/s0022215100105808.
The incidence of upper respiratory tract Candidiasis secondary to steroid aerosol treatment is disputed, and varies from series to series. We found a very low incidence of thrush, but a significant number of abnormalities of the upper respiratory tract in a random selection of asthmatics on steroid inhaler. A minority had positive Candida cultures, but 37 per cent had symptoms which were minor and self-limiting, but a complaint of hoarseness in asthmatics on steroid inhalers should be referred to a laryngologist, even if there is no evidence of fungal infection in order to ascertain the nature of the laryngeal abnormality, such as adductor cord paralysis, or even carcinoma. This study also implies that the history from a patient with laryngeal or pharyngeal symptoms is incomplete unless the patient's aerosol medication is also taken into account, as signs and symptoms in this group of patients are usually reversible when alternative treatment for asthma is instituted.
类固醇气雾剂治疗继发上呼吸道念珠菌病的发生率存在争议，且各系列报道有所不同。我们发现鹅口疮的发生率很低，但在随机选取的使用类固醇吸入器的哮喘患者中，上呼吸道有大量异常情况。少数患者念珠菌培养呈阳性，但37%的患者有轻微且自限性的症状，不过，即使没有真菌感染的证据，使用类固醇吸入器的哮喘患者若出现声音嘶哑的症状，也应转诊给喉科医生，以确定喉部异常的性质，如内收肌麻痹，甚至是癌症。这项研究还表明，除非考虑患者的气雾剂用药情况，否则有喉或咽症状患者的病史是不完整的，因为当采用替代的哮喘治疗方法时，这类患者的体征和症状通常是可逆的。
