■蝶形曲霉病是一种罕见的严重疾病,可能导致致命的结果。它的管理存在困境。有关此病理学的已发布数据有限,因此我们发现将我们的经验添加到文献中很有趣。事实上,这项工作通过提供病例报告和文献复习,重点描述了该实体的临床特征及其管理。
方法:我们报告了一例53岁的男性,他在我们大学教学医院的门诊部就诊,患有孤立的慢性头痛投诉,该投诉持续了两年。他的身体检查没有发现异常。面部骨的CT扫描和MRI显示有利于蝶骨曲霉病的一个方面。他接受了内窥镜蝶窦切开术。显微镜检查与蝶窦曲霉菌病的诊断一致。由于我们估计手术切除已完成,因此无需进行抗真菌治疗。患者在手术后4年的随访中保持无病。
■曲霉病在自然界中普遍存在,目前在免疫功能正常和免疫功能低下的患者中引起严重的疾病。由于抗生素的广泛使用,其频率在过去几年中有所增加,皮质类固醇,和改进的诊断方法。手术是主要的治疗方式,但是如果有入侵的迹象,它应该补充抗真菌治疗。
结论:蝶骨曲霉病是一种罕见的疾病,其诊断并不总是很明显。在慢性鼻窦炎患者中,临床医生应始终牢记这一诊断,避免可能危及生命的侵入性和暴发性形式。
UNASSIGNED: Sphenoidal aspergillosis is an uncommon serious condition that could lead to a fatal outcome. There is dilemma in its management. Published data concerning this pathology are limited so we find interesting in adding our experience to the literature mass. In fact, this work focused on the description of the clinical features of this entity as well as its management by presenting a
case report and reviewing literature.
METHODS: We report a
case of 53 years old male who presented to the outpatient department of our university teaching Hospital with isolated chronic headache complaint that evolving through two years. His physical examination revealed no abnormalities. CT scan of facial bone and MRI showed an aspect in favor of sphenoidal aspergillosis. He underwent an endoscopic sphenoidotomy. Microscopic examination was consistent with the diagnosis of sphenoidal aspergillosis. There were no needs to associate an antifungal treatment since we estimate the surgery excision was complete. The patient remained free of disease after surgery for a follow-up of 4 years.
UNASSIGNED: Aspergillosis is ubiquitous in nature, currently causing severe disease in both immunocompetent and immunocompromised patients. Its frequency has increased over the past few years due to the widespread use of antibiotics, corticosteroids, and improved diagnostic methods. Surgery is the primary form of treatment, however if signs of invasion are present, it should be supplemented with an anti-fungal treatment.
CONCLUSIONS: Sphenoidal aspergillosis is a rare condition whose diagnosis is not always obvious. The clinician should always bear this diagnosis in mind in patients with chronic sinusitis avoiding invasive and fulminant forms which could be life-threatening.