摘要
鼻顏部接合菌症（zygomycosis）為一局限於頭部，尤其是鼻部與顏面的黴菌感染。多見於熱帶地區，台灣過去未有病例報告。本院於1997年經歷1例上述病患。病人為農夫，因鼻塞於1996年底及1997年初於他院進行2次鼻部手術，由於鼻塞再度發作及兩頰和鼻側出現節結狀病灶而至本院就診，經手術切除鼻內病灶，病理檢查發現內芽腫及Langhans’ giant cells，於是試投予抗結核藥物，經2個月後病灶反而更惡化，於是再度切片檢查，發現組織中有菌絲體，明顯的異物肉芽腫及嗜伊紅性白血球浸潤，改投予碘化鉀、Baktar及Pred-nisolone，病人反應良好，病灶開始出現明顯消退。病人目前於門診追蹤中，無復發跡象。
並列摘要
Nasofacial zygomycosis is a fungal infection localized in the nasal cavity, sinuses and surrounding subcutaneous tissue. Most cases are found in tropical areas especially in Africa. Yet, it is rather rare in Taiwan. We report a case of nasofacial zygomycosis in a 64 year-old Taiwanese man who is a farmer. He complained of recurrent nasal obstruction after two nasal surgeries. The first biopsy from soft tissue in the nasofacial area showed granulomatous inflamma-tion with Langhans’ giant cells. Anti-tuberculous agents were given without improvement. A repeat biopsy two months later revealed hyphae, granuloma and eosinophil infiltration. He was then treated with potassium iodine (KI), co-trimoxazole and prednisolone with good response. However, a high serum potassium was noted when he took KI 2.2g four time a day. The serum potas-sium level decreased to normal limits after the KI concentration was reduced to 0.66 g. No recurrence has been noted after one and a half years. In Taiwan, it is important to differentiate nasofacial zygomycosis from tuberculo-sis.
延伸閱讀
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