Fujimoto Takashi, Morofuji Yoichi, Hiu Takeshi, Yoshida Koichi, Izumikawa Koichi, Watanabe Takeshi, Matsuo Takayuki
Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
Department of Infectious Disease, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
NMC Case Rep J. 2021 Jun 23;8(1):343-347. doi: 10.2176/nmccrj.cr.2020-0189. eCollection 2021.
Invasive sphenoid sinus aspergillosis is a rare infection and usually affecting immunocompromised patients. We describe an invasive sphenoid sinus aspergillosis patient with immunocompetent who present progressive ocular dysfunctions. A 66-year-old woman with no history of immune dysfunction was referred to our hospital with orbital complications. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a mass lesion extending from the left orbital apex to the sphenoid sinus. Inflammatory diseases were not suspected by laboratory findings, but a transnasal endoscopic biopsy revealed sphenoid sinus aspergillosis. After treatment of antifungal medication, this patient showed improvement and no sign of recurrence during the follow-up period. Diagnosis of invasive sphenoid sinus aspergillosis in an immunocompetent, healthy individual, was challenging. However, if patients have sinus wall deformities and orbital complications, early surgery is necessary to improve their prognosis.
侵袭性蝶窦曲霉菌病是一种罕见的感染，通常影响免疫功能低下的患者。我们描述了一名免疫功能正常但出现进行性眼功能障碍的侵袭性蝶窦曲霉菌病患者。一名无免疫功能障碍病史的66岁女性因眼眶并发症被转诊至我院。计算机断层扫描（CT）和磁共振成像（MRI）显示有一个肿块病变，从左眶尖延伸至蝶窦。实验室检查结果未怀疑有炎症性疾病，但经鼻内镜活检显示为蝶窦曲霉菌病。经过抗真菌药物治疗，该患者病情好转，随访期间无复发迹象。在免疫功能正常的健康个体中诊断侵袭性蝶窦曲霉菌病具有挑战性。然而，如果患者有鼻窦壁畸形和眼眶并发症，早期手术对于改善其预后是必要的。
