声带曲菌病6例报告

目的探讨声带曲菌病的实验诊断和治疗方法。方法分析我院门诊2007年3月～2008年9月间6例声带曲菌病患者的临床资料，总结经验教训。结果本文6例门诊患者声带活检，标本分别作真菌检验和病理检验。真菌直接镜检阳性1例，培养有4例烟曲菌生长和2例黄曲菌生长；病理检验均显示声带坏死组织中大量中性粒细胞、浆细胞及淋巴细胞浸润，4例可见大量菌丝，呈45。分支透明有隔菌丝。嘱患者禁声3d，停用抗生素。予伊曲康唑胶囊0．2g，口服2次／d，14d后减量为0．1g，口服1次／d，7d后停药。患者服药3～4d后能够发声，10d后声音嘶哑症状消失。1—3个月后复查电子喉镜均显示：假膜消失，声带光滑，闭合正常。随访1个月-1年半，6例声音完全恢复正常，声带光滑，声带无充血现象，无复发。结论治疗声带曲菌病应要求患者禁声并停用抗生素，同时予抗真菌药物治疗至关重要。

Vocal cords aspergillosis:report of 6 cases

Objective To investigate experimental diagnosis and treatment of vocal aspergillosis. Methods Six cases of aspergillosis in the vocal cords in our hospital out-patient department from March 2007 to September 2008 were analyzed and summarized. Results All the patients were detected by vocal biopsy for microscopic observation and pathological examination. One ease showed positive for direct microscopic observation. All of 6 cases were positive for fungal culture,including 4 cases as Aspergillus fumigatus and the other 2 as Aspergillusflavus . Large numbers of neutrophils, plasma cells and lymphocytes were found to infiltrate in the necrotic tissue with much 45-degree branching hyphae in 4 cases. All the patients were voice rested for 3 days without using any antibiotics. They were administered with oral itraconazole 0.2 g,twice a day,for 14 days,then 0.1 g,once a day,for 7 days. Patients with medication changed to audible 3-4 days later, hoarseness disappeared after 10 days. Telectronic laryngoscope reexamination after 1-3 months showed that pseudome disappear and vocal became smooth. Voices of all 6 patients were completely recovered, and the vocal cords were smooth without congestive phenomenon and recurrence in the follow-up from 1 month to one and a half years. Conclusions Voice resting antibiotics stopping and antifungal agents applying are important in the treatment of aspergillosis in the vocal cord.