Allergic fungal sinusitis caused by Bipolaris (Drechslera) hawaiiensis
| Autor: | A. Fryen, H. Breithaupt, G.S. de Hoog, Peter Mayser, H. Glanz, R. Füssle |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Microsurgery Pathology medicine.medical_specialty Therapeutic irrigation Amaurosis Amphotericin B Paranasal Sinuses Respiratory Hypersensitivity medicine Humans Sinusitis Therapeutic Irrigation Patient Care Team biology business.industry Endoscopy General Medicine biology.organism_classification medicine.disease Bipolaris Magnetic Resonance Imaging Paranasal sinuses medicine.anatomical_structure Debridement Otorhinolaryngology Drug Therapy Combination Female Drechslera Mitosporic Fungi Itraconazole Immunocompetence business Allergic process |
| Zdroj: | European Archives of Oto-Rhino-Laryngology. 256:330-334 |
| ISSN: | 1434-4726 0937-4477 |
| DOI: | 10.1007/s004050050157 |
| Popis: | Depending on the aggressiveness of the pathogen and a patient's immunocompetence, fungal polypoid pansinusitis or allergic fungal sinusitis (AFS) may be a life-threatening disease. Apart from the clinical findings, its diagnosis is based on the demonstration of mucinous material with abundant eosinophils in the paranasal sinuses (indicating an allergic process), cultivation of the causative pathogen and immunocompetence of the patient. In a 20-year-old immigrant Sudanese woman, AFS due to Bipolaris (Drechslera) hawaiiensis was diagnosed. Because of intracranial extension, the disease had led to erosion of the cranial base and orbit with amaurosis on the right side and focal epilepsy. In addition to endonasal microsurgical pansinus operations, local irrigation therapy with amphothericin B was accompanied by systemic treatment with itraconazole after in vitro cultivation of the pathogen and determination of its sensitivities. Interdisciplinary management included a combination of endonasal surgery with debridement of infected tissues and wide drainage of the sinuses without removal of skull bone or the dural lesion in addition to specific antimycotic treatment. Injury to adjacent anatomical structures must be avoided in any case to prevent systemic or possibly lethal dissemination of infection. |
| Databáze: | OpenAIRE |
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