11例声带真菌感染误诊临床分析
Clinical Analysis of Misdiagnosis of Fungal Infection of Vocal Cord in 11 Patients
文森林 1葛士波 1周永青 1邸斌 1宋琦 1肖淑芬 1李震 1李晓明1
作者信息
- 1. 050081 石家庄,解放军联勤保障部队第九八〇医院耳鼻咽喉头颈外科
- 折叠
摘要
目的 探讨声带真菌感染的病因、临床特点、误诊原因、诊断与治疗方法.方法 回顾分析2022 年6 月至2023 年12 月诊治的11 例声带真菌感染患者临床资料.结果 11 例均因声音嘶哑就诊,均有上呼吸道感染史、长期抗生素使用史及长期糖皮质激素使用史,外院诊断为声带炎4 例、急性喉炎 7 例,后经电子喉镜检查提示双侧声带急性充血,表面覆盖大片灰白色或灰黄色豆腐渣样膜状物,病理检查均确诊声带真菌感染,误诊时间 3～23 d.经休声、停用抗生素及糖皮质激素,并予抗真菌治疗1 个月后治愈,随访半年以上均无复发.结论 声带真菌感染多于上呼吸道感染后、滥用抗生素及糖皮质激素后发病,易误诊误治;病理检查是本病诊断金标准,当电子喉镜检查发现双侧声带表面大片伪膜附着、溃疡、肉芽肿时,应及时行病理检查以确诊,全身使用抗真菌药物可治愈.
Abstract
Objective To investigate the etiology,clinical characteristics,causes of misdiagnosis,diagnosis and treatment of fungal infection of vocal cord.Methods The clinical data of 11 patients with fungal infection of vocal cord from June 2022 to December 2023 were retrospectively analyzed.Results All 11 patients presented with hoarseness and had a his-tory of upper respiratory tract infection,long-term antibiotic use and long-term glucocorticoid use.Four patients were diag-nosed as vocal cord inflammation and 7 patients as acute laryngitis in other hospitals.Subsequently,electronic laryngoscopy examination showed acute congestion of both vocal cords,with large areas of gray white or gray yellow film like beancurd resi-due covering the surface.After pathological examination,fungal infection of vocal cord was confirmed,and the duration of misdiagnosis was 3-23 d.After resting the voice,discontinuing antibiotics and corticosteroids,and receiving antifungal treat-ment for one month,the patient was cured,and there was no recurrence after follow-up for more than 6 months.Conclusion Fungal infection of vocal cord is more common after upper respiratory tract infection and abuse of antibiotics and glucocorti-coids,which is prone to misdiagnosis and mistreatment.Pathological examination is the gold standard for the diagnosis of this disease.When electronic laryngoscopy reveals large pseudomembrane attachment,ulceration and granuloma on the surface of bilateral vocal cords,pathological examination should be performed in time to confirm the diagnosis,and systemic antifungal drugs can help cure the disease.
关键词
真菌感染/声带/误诊/声带炎/急性喉炎/组织病理检查Key words
Fungal infection/Vocal cords/Misdiagnosis/Vocal chorditis/Acute laryngitis/Histopathological exam-ination引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据