EPIDEMIOLOGY AND PATHOGENESIS OF PARANASAL SINUS MYCOSES
EPIDEMIOLOGY AND PATHOGENESIS OF PARANASAL SINUS MYCOSES
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DOI：
10.1177/019459988910700606.1
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发表时间：
1992-12-01
影响因子：
3.4
通讯作者：
CHANDER, J
中科院分区：
文献类型：
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作者：
CHAKRABARTI, A;SHARMA, SC;CHANDER, J
在一项前瞻性研究中，来自印度北部的 119 名临床疑似患者中，2 年内诊断出 50 例鼻旁窦真菌病。来自农村地区的年轻人最常受到影响。鼻旁窦真菌病患者可分为三种临床类型：非侵入性，31 名；非侵入性，31 名；非侵入性，31 名。侵入性，17；过敏，2.上颌窦和筛窦是这些患者同时受累的常见鼻窦，而蝶窦和额窦也有侵入性受累。黄曲霉 (80%) 是最常见的分离菌，其次是烟曲霉 (6%)。在两名非侵袭性肉芽肿患者中鉴定出链格孢属。在入侵品种中，无根根霉和白色念珠菌分别是两名患者和一名患者的病原体。关于发病机制，除了流行病学因素外，还评估了免疫学因素。研究发现，针对病原体抗原的沉淀抗体的存在与否与疾病进展密切相关。尽管只有 29% 的非侵袭性肉芽肿患者存在细胞介导的免疫，但在所有品种中均发现了过敏因素。因此，一开始就将曲霉素皮试和沉淀素演示结合起来将有助于初步筛选。
In a prospective study, 50 cases of paranasal sinus mycoses were diagnosed in 2 years out of 119 clinically suspected patients from north India. Young men from rural areas were most commonly afflicted. Patients with paranasal sinus mycoses could be grouped In three clinical varieties: noninvasive, 31; invasive, 17; allergic, 2. Maxillary and ethmoid were the common sinuses concurrently involved in these patients, whereas sphenoid and frontal sinuses were also affected in invasive variety. Aspergillus flavus (80%) was the most common isolate, followed by A. fumigatus (6%). Alternaria species was identified in two patients with noninvasive granuloma. In invasive variety, Rhizopus arrhizus and Candida albicans were the causative agents in two patients and one patient, respectively. Regarding pathogenesis besides epidemiologic factors, the immunologic factors were also evaluated. It was found that presence or absence of precipitating antibody against antigens from the etiologic agents correlates well with disease progression. Allergic factor was found in all varieties, though presence of cell-mediated immunity was demonstrated in 29% patients with noninvasive granuloma only. The combination of skin test against aspergillin and precipitin demonstration at the outset will therefore help in preliminary screening.