Iwen P C, Rupp M E, Hinrichs S H
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-6495, USA.
Clin Infect Dis. 1997 Jun;24(6):1178-84. doi: 10.1086/513662.
A 10-year retrospective analysis of invasive mold infections in hospitalized patients was performed to characterize the epidemiology and clinical features of invasive fungal sinusitis. Seventeen cases of invasive mold sinusitis were identified. Eleven cases were caused by Aspergillus flavus, three were caused by unspecified species, and one each was caused by Aspergillus fumigatus, Rhizopus species, and Alternaria species, respectively. Fifteen patients had hematologic malignancies, and two had end-stage liver disease. The most common presenting symptom was periorbital swelling (seven patients). Sinusitis was diagnosed a median of 19 days after admission. Eight patients (47%) survived; six of these patients were treated with both amphotericin B and surgery. Postmortem examination of six patients showed evidence of disseminated disease; the brain was the most common extrapulmonary site (four patients). To our knowledge, this is the largest currently reported series on invasive mold sinusitis; our report extends the information on invasive mold sinusitis and shows that aggressive therapeutic and surgical interventions are needed to prevent rapid progression of disease in immunocompromised patients.
对住院患者侵袭性霉菌感染进行了一项为期10年的回顾性分析，以描述侵袭性真菌性鼻窦炎的流行病学和临床特征。确定了17例侵袭性霉菌性鼻窦炎病例。11例由黄曲霉引起，3例由未明确的菌种引起，1例分别由烟曲霉、根霉属和链格孢属引起。15例患者患有血液系统恶性肿瘤，2例患有终末期肝病。最常见的症状是眶周肿胀（7例患者）。鼻窦炎在入院后中位19天被诊断出来。8例患者（47%）存活；其中6例患者接受了两性霉素B和手术治疗。6例患者的尸检显示有播散性疾病的证据；脑是最常见的肺外部位（4例患者）。据我们所知，这是目前报道的关于侵袭性霉菌性鼻窦炎的最大系列研究；我们的报告扩展了关于侵袭性霉菌性鼻窦炎的信息，并表明需要积极的治疗和手术干预以防止免疫功能低下患者疾病的快速进展。
