免疫功能正常患者的原发性喉曲菌病

K. Rajmohan, Inam Danish Khan, U. Kapoor, Syed Asif Hashmi, R. Gupta, S. Sen, G. Nair, K. Singh, K. Tandel, M. Malik
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引用次数: 1

摘要

背景曲霉是一种固有的普遍存在的弱致病性真菌,可引起机会性感染。它很少局限于喉部,尽管免疫功能低下的患者(包括白血病和严重再生障碍性贫血患者)可能会发展为喉部曲霉菌病。客观的本研究的目的是通过一例病例报告来探讨一名免疫活性患者的原发性喉曲霉菌病。方法。本文报告一位免疫功能正常的病人的原发性喉曲霉菌病病例。后果一名40岁的男性患者,表现为慢性加重的声音嘶哑,在视频频闪仪上发现左声带粘膜下生长光滑、白色球状,双侧声带运动保持不变。声带生长的组织病理学检查显示鳞状上皮含有间隔菌丝,具有与曲霉菌一致的锐角二歧分支模式。口服伊曲康唑200mg/天四周疗程后,声音有所改善。24个月的治疗后随访并不显著。结论。原发性喉曲霉菌病发生在免疫功能正常的患者中。医源性、言语虐待、职业和生活方式因素可能是促成因素。最佳诊断和管理要求高怀疑指数。
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PRIMARY LARYNGEAL ASPERGILLOSIS IN AN IMMUNOCOMPETENT PATIENT
Background. Aspergillus is an inherently ubiquitous, weakly pathogenic fungus causing opportunistic infections. It is very rarely localized in the larynx, although laryngeal Aspergillosis may develop in the immunocompromised patients including those with leukaemia and severe aplastic anaemia. Objective. The aim of the research was to explore the primary laryngeal Aspergillosis in an immunocompetent patient thru a case report. Methods. A case report of primary laryngeal Aspergillosis in an immunocompetent patient is presented. Results. A male patient of 40 years old, presenting with chronic worsening hoarseness, was found to have a smooth, white spheroid submucosal growth on left vocal cord with preserved bilateral cord movements on videostroboscopy. Histopathological examination of vocal cord growth revealed squamous epithelium containing septate hyphae with acute angle dichotomous branching pattern consistent with Aspergillus. Voice improved after a four-week course of oral itraconazole 200 mg/day. Post therapy follow up of 24 months was unremarkable. Conclusions. Primary laryngeal Aspergillosis develops in the immunocompetent patients. Iatrogenic, vocal abuse, occupation and lifestyle factors may be contributory. Optimal diagnosis and management mandates a high index of suspicion.
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审稿时长
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