Grzybica zatok przynosowych – trudności w diagnostyce i leczeniu

Abstract

Summary Introduction The aim of this work was to reveal the problems of diagnostics and treatments of fungal rhinosinisitis. Material and methods Material includes 6 patients (4 women and 2 man, average age 55) treated between years 2005-2010 in the ENT Department of Silesian Medical University in Katowice. All patients were treated by surgery in general anesthesia. All patients had performed CT scan of paranasal sinus before surgical procedures. Removed materials were send to a histological and microbiological examination. Results In the studied material were 5 cases of noninvasive fungal rhinosinusitis (3 case of a fungal rhonosinusitis of the right and 2 of the left maxillary sinus) and 1 case of an invasive fungal rhinosinusitis that coused destroyment of apper and lower wall of the maxillary sinus and penetration to the right orbital. All patients underwent external approach surgery under general anesthesia. All of examinations the histological and microbiological confirmed fungal etiology (Aspergillus). A possible factor in the development of fungal sinusitis in one patient was previously treated pulmonary aspergillosis, but in a patient with invasive fungal sinusitis probably played a role in type 2 diabetes and old age. Pharmacotherapy included in a patient with invasive fungal sinusitis (Amphotericin B ® ) and in a patient with a history of lung Aspergillozie (Orungal ® ). The results of the control CT scan obtained full recovery. Conclusion Fungal infection of paranasal sinuses is a problem located at the intersection of many medical specialties. Force look at the patient in a multidisciplinary. Do not forget that it may be the final diagnosis as well as a symptom of immune deficiency, or metabolic disorders.