颅底侵袭性曲霉菌感染的临床分析

Clinical analysis 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患者，详细描述其临床表现、影像学特征、手术及抗真菌治疗过程，并复习总结相关文献。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。

Abstract:

Objective To investigate the clinical manifestations, diagnostic methods and treatment strategies of patients with invasive aspergillosis of the skull base in immunocompetent individuals.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.Conclusions Invasive aspergillosis of the skull base is rare in immunocompetent patients and challenging to diagnose. Typical appearances in image examinations are helpful for differential diagnosis. Endoscopic surgery combined with long-term antifungal therapy is an effective treatment strategy. Early diagnosis and aggressive treatment are crucial for improving prognosis.