Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibi...Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibiotics and have stents; however, fungal masses, or "balls", that fully obstruct the biliary system are uncommon and exceedingly diff icult to eradicate. We present 4 cases of obstructing fungal cholangitis in patients who had metal biliary stents placed for pancreatic malignancies, and subsequently required aggressive antifungal administration along with endoscopic and radiologic interventions. This report also reviews approaches previously undertaken to manage severe obstructing fungal cholangitis.展开更多
BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal r...BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal rhinosinusitis is higher than that in other provinces. However, its physiological mechanism is not yet clear.Not every patient colonized by fungi develops a fungal infection. To a large extent, the immune status of the patient determines the nature of fungal disease in the nasal passages. The pathologic process of progression from harmless fungal colonization to fungal rhinosinusitis is unclear and has not been reported.CASE SUMMURY We report two patients, one who developed fungal rhinosinusitis 1.5 years after surgery performed to treat an inverted papilloma, and the other with a history of hypertension and cerebral infarction. Both patients recovered from their surgeries. An average time of 2.5 years elapsed from the development of maxillary sinus cysts to the development of fungal rhinosinusitis.CONCLUSION According to these case reports, we speculate that the progression of fungal rhinosinusitis from harmless colonization to disease onset requires approximately one to three years and that the length of the process may be related to underlying diseases, surgical treatment, deficient autoimmune status,and abuse of hormone antibiotics and hormones. Additional data are needed to conduct relevant studies to appropriately prevent and treat fungal rhinosinusitis.展开更多
Fungal infection usually involves the paranasal sinuses. This is a rare case of fungal mass in concha bullosa. A 19-year-old immunocompetent female patient presented with nasal obstruction. Anterior rhinoscopy reveale...Fungal infection usually involves the paranasal sinuses. This is a rare case of fungal mass in concha bullosa. A 19-year-old immunocompetent female patient presented with nasal obstruction. Anterior rhinoscopy revealed enlarged middle turbinate on left side. CT showed heterogenous opacity and enlargement of left middle turbinate. Intraoperatively, middle turbinate was found to be filled with cheesy material which was culture positive for Aspergillus fumigatus.展开更多
Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi. Endoscopic sinus surgery (ESS) has become the gold standard trea...Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi. Endoscopic sinus surgery (ESS) has become the gold standard treatment for non-invasive FRS including sinus fungal ball. It is considered to be an effective and safe procedure. It is important to keep a sufficient field of view in order to remove the fungal debris completely. ESS should also prevent damage to the nasal cavity structures including the inferior turbinate. This report mainly describes the endoscopic surgical procedures for fungal ball of the maxillary sinus (sinus mycelia) based on our methods and review of the literature, including written articles in Japanese. ESS procedures include the middle meatus approach for the maxillary sinus, the combined approach (both middle and inferior meatal antrostomy) for the maxillary sinus, and endoscopic modified medial maxillectomy (EMMM).展开更多
文摘Biliary obstructions can lead to infections of the biliary system, particularly in patients with occluded biliary stents. Fungal organisms are frequently found in bili-ary aspirates of patients who have been on antibiotics and have stents; however, fungal masses, or "balls", that fully obstruct the biliary system are uncommon and exceedingly diff icult to eradicate. We present 4 cases of obstructing fungal cholangitis in patients who had metal biliary stents placed for pancreatic malignancies, and subsequently required aggressive antifungal administration along with endoscopic and radiologic interventions. This report also reviews approaches previously undertaken to manage severe obstructing fungal cholangitis.
文摘BACKGROUND Fungal rhinosinusitis is an infectious and/or allergic disease caused by fungi in the sinus and nasal cavity. Due to the warm and humid climate in Guangxi Zhuang Autonomous Region, the incidence of fungal rhinosinusitis is higher than that in other provinces. However, its physiological mechanism is not yet clear.Not every patient colonized by fungi develops a fungal infection. To a large extent, the immune status of the patient determines the nature of fungal disease in the nasal passages. The pathologic process of progression from harmless fungal colonization to fungal rhinosinusitis is unclear and has not been reported.CASE SUMMURY We report two patients, one who developed fungal rhinosinusitis 1.5 years after surgery performed to treat an inverted papilloma, and the other with a history of hypertension and cerebral infarction. Both patients recovered from their surgeries. An average time of 2.5 years elapsed from the development of maxillary sinus cysts to the development of fungal rhinosinusitis.CONCLUSION According to these case reports, we speculate that the progression of fungal rhinosinusitis from harmless colonization to disease onset requires approximately one to three years and that the length of the process may be related to underlying diseases, surgical treatment, deficient autoimmune status,and abuse of hormone antibiotics and hormones. Additional data are needed to conduct relevant studies to appropriately prevent and treat fungal rhinosinusitis.
文摘Fungal infection usually involves the paranasal sinuses. This is a rare case of fungal mass in concha bullosa. A 19-year-old immunocompetent female patient presented with nasal obstruction. Anterior rhinoscopy revealed enlarged middle turbinate on left side. CT showed heterogenous opacity and enlargement of left middle turbinate. Intraoperatively, middle turbinate was found to be filled with cheesy material which was culture positive for Aspergillus fumigatus.
文摘Fungal rhinosinusitis (FRS) is categorized as being either invasive or non-invasive based on the histopathological evidence of tissue invasion by fungi. Endoscopic sinus surgery (ESS) has become the gold standard treatment for non-invasive FRS including sinus fungal ball. It is considered to be an effective and safe procedure. It is important to keep a sufficient field of view in order to remove the fungal debris completely. ESS should also prevent damage to the nasal cavity structures including the inferior turbinate. This report mainly describes the endoscopic surgical procedures for fungal ball of the maxillary sinus (sinus mycelia) based on our methods and review of the literature, including written articles in Japanese. ESS procedures include the middle meatus approach for the maxillary sinus, the combined approach (both middle and inferior meatal antrostomy) for the maxillary sinus, and endoscopic modified medial maxillectomy (EMMM).
