多発性脳膿瘍を合併した蝶形骨洞アスペルギルス症例

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We report a case of sphenoid sinus aspergillosis with concomitant multiple brain abscesses. A 41-year-old man seen for headache, high fever, and diplopia was found in magnetic resonance imaging (MRI) to have an abnormal sphenoid sinus shadow. Computed tomography (CT) confirmed the right sphenoid sinus shadow with mixed high- and low-density areas. MRI also showed temporal and frontal lobe brain abscesses to be gradually growing, necessitating immediate endoscopic and endonasal sphenoidectomy under general anesthesia. The right sphenoid sinus contained a fungus ball in muddy green pus but now no bacteria or fungi grew from the pus. Histopathological examination showed the fungus to be a fungal-thread bolus with identifiable septa. The definitive diagnosis was invasive sphenoid sinus aspergillosis with multiple brain abscesses. Antifungal drug administration for six months postoperatively, resulting in an uneventful recovery.
耳鼻咽喉科臨床学会の論文