摘要
喉部麴菌感染相當罕見，常為伺機性的感染，大多侵犯免疫系統有缺陷或受損的病患，致病途徑為吸入麴菌孢子，感染部位以呼吸道為主。自從1969年Rao初次提出報告後，至今英文文獻記載約有22個病例。本科於2005年12月經歷一名51歲男性，主訴聲音沙啞已3週，喉內視鏡檢查發現，聲帶兩側前三分之一處，有白色突起病變，之後安排喉顯微手術，組織切片在顯微鏡下可見麴菌特有的菌絲型態。經抽血、肺部電腦斷層及支氣管鏡檢查後，排除肺部感染可能，診斷為原發性喉部麴菌感染。術後給予病人抗黴菌藥(mycostatin powder)漱口治療，兩週後，聲音沙啞已改善，兩個月後，喉內視鏡檢查無復發跡象。
並列摘要
Laryngeal aspergillosis is extremely rare, is usually secondary or opportunistic, and is typically found among immunocompromised hosts. Aspergillosis is typically acquired by inhalation of airborne spores, and it can affect any organ in the body, but commonly affects the respiratory tract. As best we are aware, in 1969, Rao was the first to report on a case of primary laryngeal aspergillosis, and from a thorough review of the literature, at time of writing, about 22 cases would appear to have been reported in the literature over the preceding 30 years. In December of 2005, we encountered a 51-year- old man who presented with hoarseness, a symptom which had been present for the preceding three weeks. Upon physical examination and flexible fiberoptic laryngoscopy, bilateral whitish, protruding lesions of the anterior third of the vocal cords were noted. Biopsy specimens of the affected cords were taken by means of a laryngomicrosurgical technique. Histopathological examination of these lesions revealed the presence of coral-shaped, 45 degree-angled dichotomous branching hyphae, morphologically consistent with Aspergillus. Subsequent to a full medical work-up for this patient, a diagnosis of primary laryngeal aspergillosis was made. Postoperatively, the patient was treated with local application of mycostatin powder. Our patient's voice improved within the first two weeks of such treatment, and at follow-up two months later, the patient was asymptomatic and appeared to feature a normal larynx.
延伸閱讀
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