Fungal rhinosinusitis: a categorization and definitional schema addressing current controversies.
Fungal rhinosinusitis: a categorization and definitional schema addressing current controversies.
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DOI：
10.1002/lary.20520
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发表时间：
2009-09
期刊：
影响因子：
2.6
通讯作者：
Radotra, Bishan D.
中科院分区：
文献类型：
--
作者：
Chakrabarti, Arunaloke;Denning, David W.;Ferguson, Berrylin J.;Ponikau, Jens;Buzina, Walter;Kita, Hirohito;Marple, Bradley;Panda, Naresh;Vlaminck, Stephan;Kauffmann-Lacroix, Catherine;Das, Ashim;Singh, Paramjeet;Taj-Aldeen, Saad J.;Kantarcioglu, A. Serda;Handa, Kumud K.;Gupta, Ashok;Thungabathra, M.;Shivaprakash, Mandya R.;Bal, Amanjit;Fothergill, Annette;Radotra, Bishan D.
真菌性鼻窦炎包括广泛的免疫和病理反应，包括侵袭性、慢性、肉芽肿性和过敏性疾病。然而，在术语，发病机制和最佳管理缺乏共识。国际人类和动物真菌学会召集了一个工作组，试图就术语和疾病分类达成共识。得出的主要结论是：鼻窦炎优于鼻窦炎;急性侵袭性真菌性鼻窦炎优于暴发性或坏死性鼻窦炎，应指免疫功能低下患者病程<4周的疾病;慢性侵袭性鼻窦炎和肉芽肿性鼻窦炎都是有用的术语，包括持续时间至少3个月的局部侵袭性疾病，具有不同的病理学和临床背景;鼻窦真菌球优于鼻窦真菌瘤或曲菌球;鼻或鼻旁粘膜的局部真菌定植应被引入以指内窥镜可见的局部感染;嗜酸性粘蛋白优于过敏性粘蛋白;而过敏性真菌性鼻窦炎（AFRS）、嗜酸性真菌性鼻窦炎和嗜酸性粘蛋白性鼻窦炎（EMRS）是不精确的，需要更好的定义。特别是，要发现真菌（如AFRS和EMRS），必须在嗜酸性粘蛋白中观察到菌丝，但组织学家往往没有足够仔细地处理或检查，从而降低了疾病分类的普遍性。提出了对这些实体（包括阿司匹林加重的鼻窦炎）进行细分的模式，允许组织病理学特征重叠，并与肉芽肿性、慢性侵袭性和其他形式的鼻窦炎重叠。还确定了未来研究途径的建议。
Fungal (rhino-) sinusitis encompasses a wide spectrum of immune and pathological responses, including invasive, chronic, granulomatous, and allergic disease. However, consensus on terminology, pathogenesis, and optimal management is lacking. The International Society for Human and Animal Mycology convened a working group to attempt consensus on terminology and disease classification. Key conclusions reached were: rhinosinusitis is preferred to sinusitis; acute invasive fungal rhinosinusitis is preferred to fulminant, or necrotizing and should refer to disease of <4 weeks duration in immunocompromised patients; both chronic invasive rhinosinusitis and granulomatous rhinosinusitis were useful terms encompassing locally invasive disease over at least 3 months duration, with differing pathology and clinical settings; fungal ball of the sinus is preferred to either mycetoma or aspergilloma of the sinuses; localized fungal colonization of nasal or paranasal mucosa should be introduced to refer to localized infection visualized endoscopically; eosinophilic mucin is preferred to allergic mucin; and allergic fungal rhinosinusitis (AFRS), eosinophilic fungal rhinosinusitis, and eosinophilic mucin rhinosinusitis (EMRS) are imprecise and require better definition. In particular, to implicate fungi (as in AFRS and EMRS), hyphae must be visualized in eosinophilic mucin, but this is often not processed or examined carefully enough by histologists, reducing the universality of the disease classification. A schema for subclassifying these entities, including aspirin-exacerbated rhinosinusitis, is proposed allowing an overlap in histopathological features, and with granulomatous, chronic invasive, and other forms of rhinosinusitis. Recommendations for future research avenues were also identified.
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影响因子：
1.7
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