摘要
目的探讨真菌性鼻窦炎的临床特点及误诊原因、防范措施。方法对2021年1—12月收治曾误诊的无免疫抑制剂应用史真菌性鼻窦炎8例的临床资料进行回顾性分析。结果本组均为单个鼻窦病变,出现流脓涕5例,头面部和磨牙疼痛2例,视力下降1例。首诊皆就诊于当地社区医院或个人诊所,曾误诊为慢性鼻窦炎5例,神经痛2例,眶内感染1例,误诊时间3~11个月。8例按误诊疾病给予相应治疗效果不佳,入我院后给予手术治疗,术后病理检查均证实为真菌性鼻窦炎,其中1例诊断为慢性侵袭性真菌性蝶窦炎。8例术后给予相应治疗均病情好转。术后随访6~14个月,皆恢复良好,无复发。结论真菌性鼻窦炎临床及影像学表现缺乏特异性,易误诊。提高对其认识、加强思想重视、及时完善相关检查,并认真细致诊断和鉴别诊断可减少或避免真菌性鼻窦炎误漏诊。
Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of fungal sinusitis(FS).Methods The clinical data of 8 patients with FS but without history of immunosuppressant use treated from January to December 2021 were reviewed.Results All patients showed single sinus lesions,including 5 with rhinorrhea,2 with cephalofacial and molar pain,and 1 with visual loss.The first diagnosis was made in the local community hospital or individual clinic.There was misdiagnosis of chronic sinusitis in 5 patients,neuralgia in 2 cases,and orbital infection in 1 case.The duration of misdiagnosis was 3 to 11 months.Eight cases responded poorlt to the treatment according to misdiagnosed diseases,and were given surgical treatment after admission to our hospital.Postoperative pathological examination confirmed FS,and one of the cases was diagnosed as chronic invasive fungal sphenoidal sinusitis.After the operation,the condition of the eight patients was improved.After a postoperative follow-up of 6 to 14 months,they all recovered well without recurrence.Conclusion The clinical and imaging findings of FS lack specificity and are prone to misdiagnosis.Improving their understanding,strengthening their attention,timely performing the relevant examination,as well as careful diagnosis and differential diagnosis can reduce or avoid the misdiagnosis or missed diagnosis of FS.
作者
苏辉
李卫平
马静
范菲
张俊霞
SU Hui;LI Wei-ping;MA Jing;FAN Fei;ZHANG Jun-xia(Department of Otolaryngology,Fengfeng General Hospital of North China Medical and Health Company Ltd.,Handan,Hebei 056200,China;Department of Otolaryngology,the Second Hospital of Baoding City,Baoding,Hebei 071000,China)
出处
《临床误诊误治》
CAS
2022年第12期17-20,共4页
Clinical Misdiagnosis & Mistherapy
基金
保定市科学技术局科技计划项目(2141ZF208)。
关键词
鼻窦炎
真菌性
误诊
鼻窦炎
慢性
神经痛
眶内感染
Sinusitis,fungal
Misdiagnosis
Sinusitis,chronic
Neuralgia
Intraorbital infection
作者简介
苏辉,本科,主治医师。主要从事鼻科方向研究;通讯作者:张俊霞,E-mail:262244905@qq.com。
