颅底侵袭性曲霉菌感染2例

Two cases of invasive aspergillosis of the skull base

摘要:

目的: 探讨免疫功能正常的颅底侵袭性曲霉菌感染的患者的临床表现、诊断方法及治疗策略。方法: 报道2例免疫功能正常的颅底侵袭性曲霉菌感染病例，详细描述其临床表现、影像学特征、手术及抗真菌治疗过程，并总结相关文献报道。结果: 2例患者均通过鼻内镜手术切除病变组织，病理检查确诊为曲霉菌感染。术后给予伏立康唑长期抗真菌治疗，随访期间症状明显改善。结论: 颅底侵袭性曲霉菌感染在免疫功能正常的患者中较为罕见，诊断困难。 典型的影像学表现有助于鉴别诊断、鼻内镜手术联合长期抗真菌治疗是有效的治疗策略，早期诊断和积极治疗对改善预后至关重要。

关键词:侵袭性曲霉菌病;颅底;免疫功能正常;

Abstract:

Objective: To investigate the clinical manifestations, diagnostic methods, and treatment strategies for invasive aspergillosis of the skull base in immunocompetent patients.Methods:Two cases of invasive aspergillosis of the skull base in immunocompetent patients were reported, detailing their clinical presentations, imaging features, surgical procedures, and antifungal treatments. Relevant literature was also reviewed.Results:Both patients underwent endoscopic surgery to remove the lesions, with pathological confirmation of Aspergillus infection. Postoperative long-term antifungal therapy with voriconazole was administered, resulting in significant symptom improvement during follow-up.Conclusion: Invasive aspergillosis of the skull base is rare in immunocompetent patients and challenging to diagnose. Typical appearances in image examminations are of help in diagnosis. Endoscopic surgery combined with long-term antifungal therapy is an effective treatment strategy. Early diagnosis and aggressive treatment are crucial for improving prognosis.

Key words:Invasive aspergillosis; Skull base; Immunocompetent.