Hronični granulomatozni invazivni gljivični sinuzitis: pregled literature i prikaz slučaja netipičnog za Balkansku regiju
Sažetak
Uvod: Hronični granulomatozni invazivni gljivični rinosinuzitis ( HGIGRS) je izuzetno redak oblik invazivnog gljivičnog sinuzitisa. Karakteriše ga dugotrajan i podmukao tok, te invazija i destrukcija u sinonazalnoj i okolnim regijama napreduju postepeno. Ova bolest se prevenstveno javlja na Bliskom istoku, u Severnoj Arfici, Indiji i Pakistanu; veoma je retka u zapadnim zemljama. Prvenstveno ga izaziva Aspergillus flavus.
Metod: Predstavljamo slučaj četrdesetogodišnjeg muškarca sa dijagnozom hroničnog granulomatoznog invazivnog gljivičnog rinosinuzitisa. Prema našim saznanjima, ovo je prvi slučaj HGIGRS prijavljen u Srbiji. Pored toga, pregledamo i podatke iz literature o ovom retkom obliku gljivičnog sinuzitisa, posebno za region Balkana.
Rezultati: Pacijent je uspešno tretiran kombinacijom hirurškog lečenja i postoperativno ordiniranog vorikonazola. Histopatološka analiza je bila neophodna za postavljanje definitivne dijagnoze. Verifikacija granulomatoznog odgovora sa fibrozom i izraženog inflamatornog infiltrata je tipična za HGIGRS.
Zaključak: Iako prikazujemo jedan izuzetno redak slučaj gljivičnog sinuzitisa za Balkanski region, važno je posumnjati na njega u svim slučajevima kada hronična upala paranazalnih sinusa ne reaguje na konvencionalno lečenje.
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