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비강 및 부비동 진균증의 임상적 고찰
Published Online: May 31, 2020
ABSTRACT
The mycotic infections of the nose and paranasal sinus had been rare occurence about a decade before. However, with the advent of therapy with antibiotics, steroids, and chemotherapeutic agents, the incidence of the fungal infection seems to have increased recently. The disease is characterized by a wide range of initial symptoms and should be considered as a possible diagnosis in case of sinusitis refractory to routine therapy. For the diagnosis, the histopathologic study with special staining methods, such as Gomori’s methenamine silver(GMS) stain or Periodic Acid-Schiff(PAS) stain, should be performed.
We analysed the clinical history and the pathologic findings of 3 cases of aspergillosis and 7 cases of mucormycosis which were diagnosed as mycotic infection of the nose and paranasal sinus and treated between June 1984 and October 1991.
The results were as follows:
The male to female ratio was 1 : 1 in total 10 cases of mycotic infection(2 : 1 in the aspergillosis and 1 : 1.3 in the mucormycosis) and the mean age was 43.8 years.
There were no underlying disease in both aspergillosis and mucormycosis except in 1 case of aspergillosis with acute myelocytic leukemia.
The intervals from the first symptom to hospital visit were as follows: 6 cases over 1 year, 3 cases within 3 months and 1 case at 4 months.
Most common clinical manifestations were purulent rhinorhea, postnasal drip, nasal obstruction, headache and foul odor.
Abnormal radiologic findings were clouding of the involved sinuses and bony destruction in 1 case.
A saddle nose deformity occurred in a case of aspergillosis with acute myelocytic leukemia, which developed in the nasal cavity in spite of the treatment with Amphotericin B.
In one case of aspergillosis and 6 cases of mucormycosis which were found incidentally following Caldwell-Luc’s operation, the follow-up results were good.