Sugata T, Myoken Y, Kyo T, Fujihara M
Hiroshima Red Cross-Atomic Bomb Survivor's Hospital, Japan.
J Oral Maxillofac Surg. 1994 Apr;52(4):382-6. doi: 10.1016/0278-2391(94)90442-1.
The clinicopathologic characteristics of invasive oral aspergillosis in 16 immunocompromised patients who developed this infection during antileukemic chemotherapy are described. The primary site of the infection was the marginal gingiva, there was severe spontaneous pain, and the patients developed spiking fever and granulocytopenia. Necrotic ulceration of the gingiva rapidly extended to the contiguous mucosa, muscle, and bone. Microscopically, the necrotic tissue contained thrombotic vascular infarcts and there were hyphae that showed frequent transverse septa and dichotomous branching. The invasive organisms were not responsive to amphotericin B in the absence of remission of the leukemia and restoration of the depressed host defenses. In 15 patients who showed improvement of hematologic status, oral aspergillosis was controlled by the combination of antifungal chemotherapy and debridement of necrotic tissues.
描述了16例在抗白血病化疗期间发生侵袭性口腔曲霉病的免疫功能低下患者的临床病理特征。感染的主要部位是边缘龈，有严重的自发痛，患者出现高热和粒细胞减少。牙龈的坏死性溃疡迅速扩展至相邻的黏膜、肌肉和骨骼。显微镜下，坏死组织包含血栓性血管梗死，并有显示频繁横隔和二叉状分支的菌丝。在白血病未缓解且宿主防御功能未恢复的情况下，侵袭性病原体对两性霉素B无反应。在15例血液学状态改善的患者中，口腔曲霉病通过抗真菌化疗和坏死组织清创术的联合得以控制。
