慢性淋巴细胞白血病(CLL)口腔和咽喉真菌病诊断的困难。

Wiadomosci parazytologiczne Pub Date : 2011-01-01
Dariusz Kaczmarczyk, Alina Morawiec-Sztandera, Izabela Niedźwiecka, Piotr Kurnatowski
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引用次数: 0

摘要

在临床实践中,真菌感染的病例越来越多。与真菌病高风险相关的因素包括皮质类固醇治疗、使用具有广谱抗菌特性的抗生素、中性粒细胞减少症、肿瘤等。真菌可能在癌症的形成中起作用,可能在治疗过程中作为并发症,并可能通过提供类似的临床图像来模拟肿瘤的过程。在真菌性喉部感染的情况下,患者主诉体温升高,一般感觉虚弱,不适,头痛,吞咽时自发疼痛加剧,喉咙有障碍或咳嗽。体格检查可发现粘膜充血,随后是单侧火山口溃疡,常被脂肪覆盖,并伴有厚涂层,并伴有足部肿大。下颌骨和颈部淋巴结通常很大且疼痛。这些症状可能与全身性疾病(粒细胞缺乏症)的肿瘤过程和变化相关。在这些病例中,正确的诊断对于适当的治疗是必要的。慢性淋巴细胞白血病(CLL)是欧洲和北美成年人中最常见的白血病类型。据估计,在波兰,CLL每年影响约1,400人。本文报告1例62岁慢性淋巴细胞白血病合并口腔及咽喉真菌感染的病例。
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Difficulties associated with the diagnosis of mycosis of the oral cavity and throat in chronic lymphocytic leukemia (CLL).

Cases of fungal infections are being encountered more often in clinical practice. The factors associated with a high risk of mycoses include, among others, corticosteroidotherapy, the administration antibiotics with wide spectrum of antibacterial properties, neutropenia, neoplasms. Fungi may play a role in cancer formation, may act as a complication in the course of treatment, and may mimic a neoplastic process by giving a similar clinical picture. In the case of fungal throat infection, patients complain of increased body temperature, a general feeling of weakness, malaise, headache, spontaneous pain intensifying during swallowing, a feeling of an obstacle in the throat or a cough. A physical examination may reveal congestion of the mucosa followed by a unilateral crater ulceration often covered with fat, as well as a thick coating, which is accompanied by foetor ex ore. The submandibular and neck lymph nodes are often greatly enlarged and painful. These symptoms may resemble those associated with the neoplastic process and changes in the course of systemic diseases (agranulocytosis). A correct diagnosis in these cases is necessary for adequate therapy. Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults in Europe and North America. It is estimated that in Poland, CLL affects approximately 1,400 people per year. In this paper, a case of 62-years old patient with CLL with fungal infection of oral cavity and throat is presented.

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