Orbital aspergillosis. Conservative debridement and local amphotericin irrigation.
Orbital aspergillosis. Conservative debridement and local amphotericin irrigation.
复制标题
眼眶曲霉菌病。
DOI：
10.1097/00002341-198909000-00012
复制
发表时间：
1989
影响因子：
2
通讯作者：
Will,BR
中科院分区：
文献类型：
--
作者：
Harris,GJ;Will,BR
：一名患者在骨髓移植后长期服用免疫抑制剂，右眼眶出现曲霉菌脓肿。在不影响视力的情况下切除脓肿，并通过留置导管定期用两性霉素 B 冲洗眼眶。后续计算机断层扫描、手术探查和组织学分析表明眼眶内真菌生长受到抑制。尽管先前已进行手术清除并持续全身性使用两性霉素 B，但从未冲洗的鼻窦中仍发现了持续存在的真菌。眼眶曲霉病的治疗应包括手术减少局部真菌接种，补充静脉注射抗真菌药物以尽量减少全身毒性，并尝试逆转免疫抑制。如果最后一个不可能，广泛清除正常的周围组织将无法阻止无处不在的真菌的重新繁殖。
: A patient maintained on long-term immunosuppressive agents after bone marrow transplantation developed an Aspergillus abscess in the right orbit. The abscess was resected without visual compromise and the orbit was irrigated regularly with amphotericin B via an indwelling catheter. Follow-up computed tomography, surgical exploration, and histological analysis demonstrated suppression of fungal growth in the orbit. Persistent fungus was recovered from nonirrigated sinuses despite their previous surgical evacuation and continued systemic amphotericin B administration. Treatment of orbital aspergillosis should include surgical reduction of the local fungal inoculum, supplementation of intravenous antifungal agents with local delivery to minimize systemic toxicity, and attempts to reverse the immunosuppression. If the last is not possible, extensive extirpation of normal surrounding tissues will not prevent repopulation by the ubiquitous fungus.