Sinonazal Mukormikoziste Erken Endoskopik Muayenenin Önemi

Abstract

Mukormikozis genellikle kontrolsüz diabetes mellitus veya immünsupresyon durumunda ortaya çıkan ölümcül olabilen mantar enfeksiyonudur. Mukormikoziste kesin tanı doku biopsisinde spesifi k mantar hifalarının görülmesiyle konulur. Mukormikozis tedavisi predispozan faktörlerin ortadan kaldırılması, tekrarlayan agresif cerrahi debridman yapılması ve anti-fungal tedaviden oluşmaktadır. Bu yazıda kliniğimizde tanısı konulmuş ve tedavisi yapılmış iki akut fulminan mukormikozisli hastanın nazal endoskopik bulguları ve radyolojik bulguları, klinik seyirleriyle birlikte güncel literatür eşliğinde sunulmuştur. Çalışmanın amacı mukormikozisin tanısında ve klinik seyrinde erken nazal endoskopik muayenenin önemini vurgulamaktır

Keywords

• Mukormikozis, Mantar, Nazal kavite, Sinüs

The Importance of Early Endoscopic Examination in Sinonasal Mucormycosis

Abstract

Mucormycosis is a fungal infection that can be fatal especially in uncontrolled diabetes mellitus or in the case of immunosuppression. The defi nitive diagnosis of mucormycosis is by cytology evaluation of specifi c fungal hyphae in the tissue biopsy. Mucormycosis treatment consists of elimination of the predisposing factors, repeated aggressive surgical debridement and anti-fungal treatment. In this report, we present two patients who were diagnosed as acute fulminant mucormycosis with the nasal endoscopic and radiological fi ndings and then treated with the clinical course and current literature. The aim of this article is to emphasize the importance of early endoscopic examination in the diagnosis and clinical course of mucormycosis

Keywords

• Mucormycosis, Fungus, Nasal cavity, Sinus

References

1. Gupta AK, Mann SB, Khosla VK, Sastry KV, Hundal JS. Non-randomized comparison of surgical modalities for paranasal sinus mycoses with intracranial extension. Mycoses 1999; 42:225-30.
2. Hilal AA, Taj-Aldeen SJ, Mirghani AH. Rhinoorbital mucormycosis secondary to Rhizopus oryzae: A case report and literature review. Ear Nose Throat J 2004; 83:556-62.
3. Hosseini SM, Borghei P. Rhinocerebral mucormycosis: Pathways of spread. Eur Arch Otorhinolaryngol 2005; 262:932-8.
4. Karcı B, Midilli R. Fungal rinosinüzitler. Türkiye Klinikleri J Surg Med Sci 2005; 1:47-53.
5. Arda B, Erdem A, Sipahi OR, Taşbakan MI, Pullukçu H, Taşbakan MS, Ceylan N, Metin DY, Midilli R, Yamazhan T, Ulusoy S. Mukormiköz: 12 olgunun retrospektif değerlendirilmesi. Mikrobiyol Bul 2011; 45:504-11.
6. Warwar RE, Bullock JD. Rhino-orbital-cerebral mucormycosis: A review. Orbit 1998; 17:237-45.
7. Cheema SA, Amin F. Five cases of rhinocerebral mucormycosis. Br J Oral Maxillofac Surg 2007; 45:161-2.
8. Pelton RW, Peterson EA, Patel BC, Davis K. Successful treatment of rhino-orbital mucormycosis without exenteration: The use of multiple treatment modalities. Ophthal Plast Reconstr Surg 2001; 17:62-6.