摘要
黴菌鼻竇炎可分為非侵犯性和侵犯性兩大類：非侵犯性包括過敏性黴菌鼻竇炎和黴菌球兩種；侵犯性黴菌鼻竇炎包括急性、慢性和肉芽型慢性三種。黴菌鼻竇炎的分類依據患者免疫狀況、臨床表現、影像學、病理和微生物檢查的結果判斷，各分類有其特徵，但也有共通的表現：過敏性黴菌鼻竇炎發生於過敏體質者；黴菌球發生在免疫力正常或稍有減弱者，常發生於單一鼻竇；侵犯性黴菌鼻竇炎常發生在免疫不全者，如嗜中性球不足、糖尿病、移植患者、長期使用類固醇者，除了感染鼻腔鼻竇，常有眼及中樞的侵犯，除造成功能損傷，亦可能發生致命性的感染。本文介紹黴菌鼻竇炎的分類和定義，並回顧國内外文獻，希望臨床醫師能熟悉黴菌鼻竇炎的診斷與治療。
並列摘要
Fungal sinusitis is classified into invasive and non-invasive forms. There are two types of non-invasive form: allergic fungal sinusitis and fungus ball, and three types of invasive form: acute, chronic, and granulomatous chronic fungal sinusitis. Allergic fungal sinusitis usually occurs in atopic subjects. Patients with fungus ball are mostly immunocompetent and present with unilateral sinusitis. Hosts with neutropenia, diabetes, or hematological malignancy, as well as patients taking immunosuppressants are at greater riskof invasive fungal infection. In addition to sinus symptoms, orbital and central nervous system involvement is not uncommon in invasive fungal sinusitis. The morbidity and mortality of invasive fungal sinusitis are both high. The purpose of this study was to review the classification and treatment of fungal sinusitis. Owing to the rising prevalence of fungal infection caused by better survival of immunocompromised hosts in the modern era, it is important to gain a better understanding of the characteristics of fungal sinusitis.
延伸閱讀
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