당뇨환자에서 발생한 두개저의 침습성 아스페르길루스증 1예A Case of Invasive Aspergillosis of Skull Base in a Diabetic Patient
- Other Titles
- A Case of Invasive Aspergillosis of Skull Base in a Diabetic Patient
- Authors
- 이지연; 김성범; 김용현; 김정한; 유상균; 김희영; 정영걸; 박승철; 정학현; 최재걸; 이진수; 김민자
- Issue Date
- Oct-2003
- Publisher
- Korean Society of Infectious Diseases; Korean Society for Antimicrobial Therapy
- Keywords
- Aspergillosis; skull base; amphotericin B; gallium scan
- Citation
- Infection and Chemotherapy, v.35, no.5, pp 310 - 314
- Pages
- 5
- Indexed
- KCICANDI
- Journal Title
- Infection and Chemotherapy
- Volume
- 35
- Number
- 5
- Start Page
- 310
- End Page
- 314
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54189
- ISSN
- 2093-2340
2092-6448
- Abstract
- Invasive aspergillosis of skull base is a rare but potentially lethal disease which complicates fungal sinusitis and requires surgical debridement, and long term antifungal therapy. However, optimal duration of antifungal therapy and standard method to monitor of clinical response are not known. A 55-year-old diabetic female patient presented with headache and otalgia 4 months after surgery for non-invasive aspergilloma of sinus. Brain MRI findings revealed bone destructions at the skull base and mastoid process. Mastoidectomy and tympanoplasty were performed, and the resected specimen showed fungal hyphae invading the tissue. Amphotericin B was given for 9 weeks (a total dose of 3.3 g) with oral itraconazole, followed by itraconazole (400 mg daily) alone for another 12 weeks. Serial gallium scans, taken before treatment and at 8th and 16th weeks following therapy, showed gradual reduction in uptake of the lesions. We emphasize that non-invasive Aspergillus sinusitis may progress to invasive disease, and strong suspicion of invasiveness is mandatory, especially in immunocompromised patients including diabetes mellitus. Also, we suggest that gallium scan is useful for determining the presence and extent of the disease, and monitoring clinical response following therapy.
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