高龄淋巴瘤患者化疗后鼻窦真菌感染1例并文献复习

王海飞; 魏建平; 齐海梅; 刘辉; 周刚

doi:10.13201/j.issn.1004-2806.2014.01.009

高龄淋巴瘤患者化疗后鼻窦真菌感染1例并文献复习

- 北京医院血液内科(北京, 100730)

详细信息

通讯作者: 魏建平,E-mail:Jianpingwei005@sina.com

中图分类号: R733.4

收稿日期: 2013-08-30

Sinus fungal infection after chemotherapy in a patient with advanced lymphoma and review of the literature

- Department of Hematology, Beijing Hospital, Beijing, 100730, China

More Information

Corresponding author: WEI Jianping, E-mail: Jianpingwei005@sina.com

Received Date: 30 August 2013

摘要

摘要: 目的:探讨老年淋巴瘤患者化疗后鼻窦真菌感染的诊断及治疗。方法:1例老年淋巴瘤患者化疗后出现右侧头痛头晕、眼胀、流泪、视力减退,头颅磁共振成像示右蝶窦炎症,累及右侧海绵窦可能;右眼眶内及右视神经异常改变,炎症可能。全身麻醉下行经鼻内镜右蝶窦开放术及真菌培养。结果:术中见窦内多量干酪样物,真菌培养为曲霉菌。病理:大量成团的曲霉样菌丝结构(有分隔及45°分支)真菌。确诊为鼻窦侵袭性曲霉菌感染。给予卡泊芬净及伏立康唑治疗后,真菌得到控制。结论:老年淋巴瘤患者化疗后鼻窦真菌感染需及早获得组织学证据,从而确诊。药物联合手术治疗是最有效的方法。
- 高龄 /
- 淋巴瘤 /
- 鼻窦 /
- 真菌感染
Abstract: Objective: To study the diagnosis and treatment of sinus fungal infection in aged patients with lymphoma after chemotherapy.Method: In a lymphoma patient with right-sided headaches and dizziness,bulging eyes,tears and blurred vision after chemotherapy,cranial MRI showed right sphenoid sinus inflammation and the right cavernous sinus may be involved.Right orbital and the right optic nerve were abnormal and inflammation may be involved.Result: During the operation of general anesthesia nasal endoscopic right sphenoidotomy,we found large quantities of caseous matter which tested as aspergillus.The pathology was fungi with aspergillus hyphae structure like large clusters (separation and 45° bifurcation).It was diagnosed as invasive aspergillosis of sinus.After caspofungin and voriconazole treatment,the fungus was controlled.Conclusion: Sinus fungal infection need early histologic evidence to be confirmed.Drug combined with operation treatment is the most effective method.
- advanced age /
- lymphoma /
- nasal sinus /
- fungus infection

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参考文献(6)

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