不幸な転帰をとった上顎洞真菌症

Lethal Aspergillosis of the Maxillary Sinus

I．はじめに

　鼻副鼻腔真菌症は本邦においても年々報告が増加しているが，比較的予後のよい疾患として従来取り扱われてきた傾向にある。今回われわれは上顎洞に原発し，眼窩翼口蓋窩に浸潤し，さらに頭蓋内にまで及んで死に至らしめたアスペルギルス症を経験したので，文献的考察を加えて報告する。

　A 79-year-old woman developed a feeling of foreign body of the right eye, and the right cheek pain. The X-ray and CT examinations showed destruction of the bony wall of the orbit and maxillary sinus. Radical Caldwell-Luc operation was carried out, and biopsy of the maxillary sinus mucosa revealed mycotic infection. The cultures yielded Aspergillus ,fumigatus. Two months after the operation, she had the right ocular proptosis. She died of cerebral edema. The autopsy revealed destruction of the cranial base on the right ethmoid sinus and fungus invasion of the right internal carotid artery with circumscribed thrombosis.