慢性肉芽肿性侵袭性真菌鼻窦炎:文献回顾和报告一个不典型的巴尔干地区

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Acta Facultatis Medicae Naissensis Pub Date : 2023-01-01 DOI:10.5937/afmnai40-37869
Milica Labus, J. Sotirović, B. Vukomanović-Đurđević, A. Perić
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引用次数: 0

摘要

介绍。慢性肉芽肿性侵袭性真菌性鼻窦炎(CGIFRS)是一种极为罕见的侵袭性真菌性鼻窦炎。本病病程长,病程缓慢,故对鼻窦及邻近区域的侵袭和破坏进展缓慢。据报告,该病主要发生在中东、北非、印度和巴基斯坦;然而,这在西方国家是非常罕见的。它主要由黄曲霉引起。病例报告。一名40岁的男性,因慢性鼻窦炎合并鼻息肉多次手术治疗,因进行性,突发性右侧突出而来到我们的耳鼻喉科。增强鼻窦计算机断层扫描(CT)显示鼻窦区软组织几乎完全混浊,骨结构侵蚀,向右眼眶扩张。右额窦壁也可见糜烂,但未见颅内扩散。最终诊断需要组织病理学检查。慢性肉芽肿性侵袭性鼻窦炎的典型特征是肉芽肿性反应伴纤维化和强烈的炎症浸润。通过手术和术后伏立康唑药物治疗,成功治疗了患者。据我们所知,这是在塞尔维亚出现的第一例CGIFRS病例。此外,我们回顾了有关这种罕见形式的真菌性鼻窦炎,特别是巴尔干地区的文献。结论。虽然我们报告了一个极其罕见的病例真菌性鼻窦炎巴尔干地区,重要的是怀疑它在所有情况下,鼻窦炎的慢性炎症不响应常规治疗。
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Chronic granulomatous invasive fungal sinusitis: A review of the literature and report of a case atypical of the Balkan region
Introduction. Chronic granulomatous invasive fungal rhinosinusitis (CGIFRS) is an extremely rare form of invasive fungal sinusitis. The disease has a long-lasting and indolent course, so the invasion and destruction in the sinonasal and adjacent regions is progressing slowly. This disease has been reported primarily in Middle East, North Africa, India and Pakistan; however, it is very rare in western countries. It is primarily caused by Aspergillus flavus. Case Report. A 40-year-old man, who was repeatedly surgically treated for chronic rhinosinusitis with nasal polyps, was presented to our Otorhinolaryngology Department with a progressive, sudden right-sided proptosis. Contrast-enhanced paranasal sinus computed tomography (CT) showed almost complete soft tissue opacification of the sinonasal region, eroded bone structures and expansion into the right orbit. Erosion of the walls of the right frontal sinus was also seen but without intracranial propagation. Histopathological examination was necessary for the final diagnosis. The finding of granulomatous response along with fibrosis and strong inflammatory infiltrate was typical for chronic granulomatous invasive fungal sinusitis. The patient was successfully treated with a combination of surgery and postoperative medical therapy with voriconazole. To our knowledge, this is the first case of CGIFRS presented in Serbia. In addition, we reviewed the literature concerning this rare form of fungal sinusitis, especially for the Balkan region. Conclusion. Although we reported an extremely rare case of fungal sinusitis for the Balkan region, it is important to suspect on it in all cases where chronic inflammation of the paranasal sinuses does not respond to conventional treatment.
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来源期刊
Acta Facultatis Medicae Naissensis
Acta Facultatis Medicae Naissensis MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
0.00%
发文量
13
审稿时长
12 weeks
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