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KMID : 0857020110260020183
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Kosin Medical Journal
2011 Volume.26 No. 2 p.183 ~ p.189
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A Case of Invasive Aspergillosis of the Paranasal Sinuses Treated with Surgery and Voriconazole after Kidney Transplantation
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Shin Ho-Sik
Lee Shin-Jun
Jung Yeon-Soon
Rim Hark
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Abstract
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Invasive fungal sinusitis is a rare, severe disease, most commonly presenting in immunocompromised patients who have
impaired neutrophil function or who have received long term immunosuppressive therapy. The gold standard for treatment
has been wide surgical debridement, intravenous administration of antifungal agents such as amphotericin B (AMB), and
correction of the underlying immunocompromised state. A 51-year-old female was admitted to our hospital with fever and
headache who had received renal transplantation 14 years ago in the other hospital. Paranasal sinus CT scan revealed hyperplasia and soft tissue density of the left maxillary sinus. Histological examination of the fungus ball and edematous mucosa of the left maxillary sinus revealed suspicious invasion of Aspergillus in the mucosa. Clinical improvement occurred after a combination of surgery and post-operative systemic antifungal therapy with voriconazole. We think that voriconazole as initial treatment may be initiated for invasive sinonasal aspergillosis, if the infection is known to be due to Aspergillus species.
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KEYWORD
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Aspergillosis, Kidney transplantation, Sinusitis, Voriconazole
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