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透析后患者鼻中隔侵袭性外生性真菌性真菌瘤:病例报告。

Invasive Eumycotic mycetoma of the nasal septum in a post-dialysis patient: A case report.

机构信息

Department of ENT, Mamata Medical College, Khammam, Telangana, 507002, India.

Department of ENT, Government Medical College, Khammam, Telangana, 507002, India.

出版信息

Eur Arch Otorhinolaryngol. 2024 Jan;281(1):509-513. doi: 10.1007/s00405-023-08261-w. Epub 2023 Oct 11.

Abstract

BACKGROUND

Mycetoma is a slowly progressive chronic granulomatous disease of the skin, subcutaneous tissue, and underlying or adjacent cartilage or bone. Most commonly involves the foot region. Other parts such as the knee, arm, leg, head, neck, thigh, perineum, chest, abdominal walls, facial bones, mandible, paranasal sinuses, eyelid, vulva, orbit, and scrotum are seldom affected.

METHODS

This is a rare presentation of Eumycotic mycetoma involving the nasal septum. Surgical debridement is done under local anesthesia. Histopathological examination of debrided specimen guided in the diagnosis and treatment.

RESULTS

Histopathological examination is the one that confirms the diagnosis and rules out the other granulomatous conditions and fungal rhinitis causing septal perforation.

CONCLUSIONS

In an immunocompromised state, we know that mucormycosis and zygomycosis are known to cause aggressive complications like orbital invasion and palatal perforation by vascular route. However, other fungal infections also can lead to septal perforations whenever there is lessened resistance by the mucosal barrier due to trauma (nasal intubations).

摘要

背景

足菌肿是一种皮肤、皮下组织和下面或相邻软骨或骨的慢性进行性肉芽肿性疾病。最常累及足部区域。其他部位如膝、臂、腿、头、颈、大腿、会阴部、胸部、腹壁、面骨、下颌骨、副鼻窦、眼睑、外阴、眼眶和阴囊很少受累。

方法

这是一个涉及鼻中隔的外生性真菌性足菌肿的罕见表现。在局部麻醉下进行手术清创。对清创标本的组织病理学检查有助于诊断和治疗。

结果

组织病理学检查是确诊的依据,并排除了其他肉芽肿性疾病和导致鼻中隔穿孔的真菌性鼻炎。

结论

在免疫功能低下的情况下,我们知道毛霉菌病和接合菌病会导致侵袭性并发症,如通过血管途径侵犯眼眶和腭穿孔。然而,当粘膜屏障因创伤(鼻插管)而减弱时,其他真菌感染也会导致鼻中隔穿孔。

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