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孤立性蝶竇麴菌症-病例報告

Isolated Aspergillosis of the Sphenoid Sinus -A Case Report

摘要


麴菌的鼻竇感染中以上頷竇最常見,篩竇及額竇次之,而蝶竇只為偶而感染。單一蝶竇之麴菌感染則甚少見。依其感染型式可分:非侵犯型、侵犯型、猛爆型,及過敏型。本院正鼻喉科於1997年10月經歷一名48歲女性病患,曾因輕度鼻涕倒流及一次鼻涕帶血絲至此部一醫學中心就診,並無明確診斷及治療,故轉至本院。病人本身並無特殊疾病或免疫狀況不良,也無頭痛之現象。電腦斷層攝影顯示左側蝶竇有一不透明之斑塊,但鼻咽部並無異常發現。經六個星期的藥物治療後,症狀卻依然存在。施行內視鏡蝶竇切開術及徹底清除麴菌後,病人狀況良好,並無復發的情形。

並列摘要


Maxillary sinus is the most frequent site of sinus aspergillosis. Infection of the ethmoid and frontal sinuses is uncommon and the sphenoid sinus is occasionally affected. Isolated aspergillosis of the sphenoid sinus is very rare. Sinus aspergillosis presents as several types: noo-invasive, invasive, fulminant and allergic. In October 1997, we experienced a 48-year-old female who suffered mild post-nasal drip and one episode of bloody whinorrhea. The patient had no systemic diseases or immunocompromised condition.CT scan of head showed normal sinuses except opacification in left sphenoid sinus, without any other abnormal findings in the nasopharyngeal area. She received medical treatment for six weeks, but the symptoms were not relieved. Endoscopic sphenoidotomy was performed and pathology revealed aspergillosis. The patient’s condition improved after surgery, and she has had no recurrence of disease after 6 months of follow up.

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