Abstract
INTRODUCTION: Aspergillosis of the paranasal sinus is a rare, opportunistic infection mostly seen in immune-compromised patients. Among Aspergillus-related paranasal sinus infections, the most commonly isolated species is Aspergillus fumigatus.
CASE REPORT: Reported here is a case of aspergillosis in the left maxillary sinus in a patient who had taken chemotherapy due to adinocarcinoma in the salivary gland. The patient was complaining of severe pain; but the source of pain could not be detected in the clinical examination. On radiographic examination of a panoramic film taken from the patient, a radio-opaque substance in the left maxillary sinus, with indefinite borders, resembling a broken root was seen. A Caldwell-Luc operation was performed under local anesthesia, and the broken root together with infected tissues were removed and sent to the Oral Pathology Department for a histopathological examination. The diagnosis was aspergillosis. After the operation, the patient was instructed to use voriconazole for two weeks (100 mg, 2x1, peroral). Checked on each third month, no clinical sign of aspergillosis was found during the 6 months follow-up period.
CONCLUSION: Aspergillosis cases, usually, may be similar to chronic sinusitis and should be approached carefully. When in doubt, pathological examination of tissues from the paranasal sinuses is recommended.
References
- Bozkurt MK, Özçelik T, Saydam L, Kutluay L. Maksiller sinüste izole aspergillus enfeksiyonu: Olgu sunumu. Kulak Burun Boğaz İhtis Derg 2008;18:53-5.
- Matjaz R, Jernej P, Mirela KR. Sinus maxillaris mycetoma of odontogenic origin: case report. Braz Dent J 2004;15:248-50.
- Chao TK. Triple discrete fungus balls of the paranasal sinuses. Otolaryngol Head Neck Surg 2004;131:1014-5.
- Khongkhunthian P, Reichart PA. Aspergillosis of the maxillary sinus as a complication of overfilling root canal material into the sinus: report of two cases. J Endod 2001;27:476-8.
- Martins W, Ribeiro Rosa EA. Aspergillosis of the maxillary sinus: review and case report. Scand J Infect Dis 2004;36:758-61.
- Taneja T, Saxena S, Aggarwal P, Reddy V. Fungal infections involving maxillary sinus-a difficult diagnostic task. J Clin Exp Dent 2011;3:72-6.
- Hachem RY, Kontoyiannis DP, Chemaly RF, Jiang Y, Reitzel R, Raad I. Utility of galactomannan enzyme immunoassay and (1,3) beta-D glucan in diagnosis of invasive fungal infections: low sensitivity for Aspergillus fumigatus infection in hematologic malignancy patients. J Clin Microbiol 2009;47:129-33.
- Chao TK. Triple discrete fungus balls of the paranasal sinuses. Otolaryngol Head Neck Surg 2004;131:1014-5.
Abstract
TANITIM: Paranazal sinüslerin aspergillozis durumu çoğunlukla immün sistemi baskılanmış hastalarda meydana gelen seyrek görülen fırsatçı bir enfeksiyondur. Aspergillus kaynaklı paranazal sinüs enfeksiyonlarında Aspergillus fumigatus en sık görülen türdür.
OLGU BİLDİRİMİ: Bu olgu sunumunda tükürük bezinde mevcut adenokarsinom nedeniyle kemoterapi tedavisi almış olan hastanın sol maksiller sinüsünde gelişen aspergillozis olgusu sunulmaktadır. Yoğun ağrı atakları şikayetiyle başvuran hastanın yapılan klinik muayenesinde herhangi bir belirgin ağrı kaynağı saptanamamıştır. Hastadan alınan panoramik radyografinin incelemesinde, sol maksiller sinüs içerisinde radyoopak ve sınırları iyi seçilemeyen, kırık bir köke benzeyen parça izlenmiştir. Lokal anestezi altında kırık kök ile enfekte dokular Caldwell-Luc operasyonu ile alınarak Oral Patoloji Anabilim Dalına histopatolojik inceleme için gönderilmis ve vakaya aspergillozis tanısı konulmuştur. Operasyon sonrası hastaya iki hafta süreli vorikonazol tedavisi uygulanmıştır (100 mg, 2x1, peroral). Bu tedaviyi takiben 3 aylık periodlarla, toplam 6 ay boyunca yapılan kontrol muayenelerinde aspergillozis ile ilgili bulguya rastlanmamıştır.
SONUÇ: Kronik sinüzit ile benzerlikler gösteren aspergillozis olgusuna dikkatli yaklaşılması ve gerekli görüldüğünde paranazal sinüslerden alınan dokuların patolojik incelemesinin yapılması önerilmektedir.
References
- Bozkurt MK, Özçelik T, Saydam L, Kutluay L. Maksiller sinüste izole aspergillus enfeksiyonu: Olgu sunumu. Kulak Burun Boğaz İhtis Derg 2008;18:53-5.
- Matjaz R, Jernej P, Mirela KR. Sinus maxillaris mycetoma of odontogenic origin: case report. Braz Dent J 2004;15:248-50.
- Chao TK. Triple discrete fungus balls of the paranasal sinuses. Otolaryngol Head Neck Surg 2004;131:1014-5.
- Khongkhunthian P, Reichart PA. Aspergillosis of the maxillary sinus as a complication of overfilling root canal material into the sinus: report of two cases. J Endod 2001;27:476-8.
- Martins W, Ribeiro Rosa EA. Aspergillosis of the maxillary sinus: review and case report. Scand J Infect Dis 2004;36:758-61.
- Taneja T, Saxena S, Aggarwal P, Reddy V. Fungal infections involving maxillary sinus-a difficult diagnostic task. J Clin Exp Dent 2011;3:72-6.
- Hachem RY, Kontoyiannis DP, Chemaly RF, Jiang Y, Reitzel R, Raad I. Utility of galactomannan enzyme immunoassay and (1,3) beta-D glucan in diagnosis of invasive fungal infections: low sensitivity for Aspergillus fumigatus infection in hematologic malignancy patients. J Clin Microbiol 2009;47:129-33.
- Chao TK. Triple discrete fungus balls of the paranasal sinuses. Otolaryngol Head Neck Surg 2004;131:1014-5.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Report |
| Authors | |
| Publication Date | May 21, 2014 |
| Published in Issue | Year 2014 |