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題名 | Diabetes Complicated with Invasive Sinonasal Aspergillosis Cause Vision Loss of Right Eye: Case Report=糖尿病人併發侵襲性麴菌性鼻竇炎及右眼失明:病例報告 |
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作者 | 陳功恆; 陳重元; 林沁儀; 謝敬崇; Chen, Kung-Heng; Chen, Chung-Yuan; Lin, Chin-I; Hsieh, Jing-Tsung; |
期刊 | Medical Journal of South Taiwan |
出版日期 | 20070600 |
卷期 | 3:1 2007.06[民96.06] |
頁次 | 頁46-51 |
分類號 | 415.668 |
語文 | eng |
關鍵詞 | 糖尿病; 麴菌性鼻竇炎; 醫源性庫欣氏症候群; 視力喪失; 復健; Diabetes mellitus; Aspergillus sinusitis; Iatrogenic cushing's syndrome; Vision loss; Rehabilitation; |
中文摘要 | 我們發表一位免疫功能不全的糖尿病病人併發侵襲性麴菌性鼻竇炎案例。她是一位初診斷糖尿病併酮酸中毒且長期服用類固醇個案,此次住院併發侵襲性麴菌性鼻竇炎顱內侵犯造成右眼失明;因免疫功能不全,之後又因肺炎造成呼吸衰竭依賴呼吸器達兩個月,經胸腔物理復健治療之後成功脫離呼吸器。此個案接受過耳鼻喉科手術有病理佐證,侵襲性麴菌性鼻竇炎常見於免疫功能不全的病人;如白血球低下及長期類固醇使用者。在治療上,建議早期施行擴大清創手術並給予足量的抗黴菌藥物治療。我們的個案極為罕見,經查文獻之後,為台灣第一個糖尿病病人併發侵襲性麴菌性鼻竇炎病例報告的案例。 |
英文摘要 | We report here a case of immunocompromised diabetic patient complicated with invasive sinonasal aspergillosis. She is a newly diagnosed diabetic ketoacidosis patient on long term corticosteroid use complicated with sinonasal aspergillosis invading to right eye cause vision loss. Due to the immunocompromised state, she went through pneumonia with acute respiratory failure s/p tracheostomy and ventilator support for 2 months. She was weaned successfully and removed the tracheostomy tube depend on chest physical therapy and rehabilitation. She received operation with pathological confirmation. Invasive sinonasal aspergillosis is mostly seen in immunocompromised patients, such as neutropenia and corticosteroid use. It is recommended to perform an early expanded operation as well as to administer a sufficient amount of antifungal drugs for the treatment of destructive aspergillosis in paranasal sinuses. Our case is so rare and after review the literature, it is the first reported of diabetic patient complicated with invasive sinonasal aspergillosis in Taiwan. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。