Hou Tieying, Bell W Robert, Mesa Hector
Department of Laboratory Medicine and Pathology, Division of Head & Neck Pathology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Department of Laboratory Medicine and Pathology, Division of Neuropathology, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Pathogens. 2024 Jun 23;13(7):530. doi: 10.3390/pathogens13070530.
From the existing millions of fungal species, only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck (H&N) over a 19-year period (2005 to 2024) at a large academic healthcare system. Among the 413 documented fungal H&N infections, 336 were noninvasive, and 77 were invasive. The highest incidence of invasive infections occurred in the sinonasal cavities, with a 15-fold difference compared to other sites. Most infections affected adults over 40 years old. The most common organisms were Mucorales (51%), hyaline molds (29%), and (11%). Risk factors included malignancy, transplant, diabetes, and illicit drug use. Mortality was high in patients with malignancy and/or transplant. Infections affecting the mandible were usually a complication of osteoradionecrosis and were associated with the coinfection of Candida and Actinomyces. At other sites, infections were rare and were usually the result of penetrating injuries or immunosuppression. Treatment typically involved a combination of antifungals and surgical procedures.
在现有的数百万种真菌物种中，只有少数会引发疾病。在本研究中，我们调查了一家大型学术医疗系统在19年期间（2005年至2024年）头颈部的侵袭性真菌感染情况。在记录的413例真菌性头颈部感染中，336例为非侵袭性，77例为侵袭性。侵袭性感染的最高发病率出现在鼻窦腔，与其他部位相比有15倍的差异。大多数感染影响40岁以上的成年人。最常见的病原体是毛霉目（51%）、透明霉菌（29%）和（11%）。危险因素包括恶性肿瘤、移植、糖尿病和使用非法药物。恶性肿瘤和/或移植患者的死亡率很高。影响下颌骨的感染通常是放射性骨坏死的并发症，并且与念珠菌和放线菌的合并感染有关。在其他部位，感染很少见，通常是穿透性损伤或免疫抑制的结果。治疗通常包括抗真菌药物和外科手术的联合应用。
