Sinusitis maksilaris jamur invasif: laporan kasus
- pdf |
- DOI: https://doi.org/10.15562/ism.v14i2.1747 |
- Published: 2023-07-12
Open Access & Peer Reviewed
Multidisciplinary Journal of Science and
Medical Research
Multidisciplinary Journal of Science and
Medical Research
Abstract
Background: Acute Infection Fungal Rhinosinusitis (AIFRS) is an uncommon inflammation of the paranasal sinus mucosa. Although the incidence of fungal sinusitis is still rare, there has been an increase in cases over the past few decades. Invasive fungal sinusitis occurs more frequently in patients with weakened immune systems. Diagnosis of fungal sinusitis involves a medical history assessment, physical examination, and supportive tests such as CT-scan. CT-scan to aid in confirming the diagnosis of invasive fungal sinusitis and help in planning appropriate management. Surgery, such as the Luc-Caldwell (LCW) procedure. Through this article, the authors aim to describe cases of fungal invasive maxillary sinusitis and diagnostic approaches with CT-Scan and Luc-Caldwell's treatment (LCW).
Case Presentation: A 61-year-old male complained of swelling, pus, and pain in his right eye. He had a history of sinus surgery. Physical examination revealed swelling in the right eye, and anterior rhinoscopy showed sinuses filled with greenish secretions. A CT scan showed extensive sinus inflammation involving the right eye area. The patient was diagnosed with maxillary, ethmoid, and frontal fungal sinusitis. A Luc-Caldwell (LCW) surgery was performed in collaboration with an ophthalmologist. Following the surgery, the swelling and pus in the eye decreased, and the pain in the cheek resolved.
Conclusion: Early diagnosis is crucial in cases of suspected AIFRS to improve patient outcomes and reduce morbidity. Diagnosing this condition can be challenging due to its non-specific clinical presentation. Initial diagnostic investigations that can be performed include computed tomography (CT).
Latar Belakang: Acute Infection Fungal Rhinosinusitis (AIFRS) adalah peradangan jamur pada mukosa sinus paranasal yang jarang ditemukan. Meskipun insiden sinusitis jamur masih jarang, saat ini terjadi peningkatan kasus dalam beberapa dekade terakhir. AIFRS lebih sering terjadi pada pasien dengan sistem kekebalan tubuh yang lemah. Diagnosis AIFRS melibatkan penilaian riwayat penyakit, pemeriksaan fisik, dan penunjang seperti CT-Scan. CT-Scan membantu dalam mengonfirmasi diagnosis AIFRS dan dapat digunakan sebagai panduan tindakan bedah. Melalui artikel ini, penulis bertujuan untuk mendeskripsikan kasus mengenai sinusitis maksilaris jamur invasif dan pendekatan diagnosis dengan CT-Scan dan tatalaksana Luc-Caldwell (LCW).
Persentasi Kasus: Seorang pria berusia 61 tahun mengeluh pembengkakan, keluar nanah, dan nyeri pada mata kanannya. Pada pemeriksaan fisik didapatkan pembengkakan pada mata kanan, dan rhinoskopi anterior menunjukkan sinus yang terisi dengan sekret berwarna hijau. CT-Scan menunjukkan peradangan sinus yang luas yang melibatkan area mata kanan. Kemudian, pasien didiagnosis dengan sinusitis jamur maksila, etmoid, dan frontal. Pasien kemudian dilakukan tindakan Luc-Caldwell (LCW) oleh dokter spesialis THT-KL bekerjasama dengan seorang oftalmologis. Setelah operasi, pembengkakan dan nanah pada mata berkurang, dan nyeri pada pipi hilang.
Kesimpulan: Diagnosis dini sangat penting dalam kasus kecurigaan AIFRS untuk meningkatkan outcome pasien dan mengurangi morbiditas. Untuk mendiagnosis kasus ini bisa menjadi tantangan karena gambaran klinisnya yang tidak spesifik. Pemeriksaan diagnostik awal yang dapat dilakukan meliputi computed tomography (CT).
References
- Gustarini IA, Kristoyo I. Sinusitis Sfenoid Jamur. J THT [Internet]. 2016;9(2):50. Available from: http://journal.unair.ac.id/download-fullpapers-thtklca857230d1full.pdf
- Peral-Cagigal B, Redondo-González LM, Verrier-Hernández A. Invasive maxillary sinus aspergillosis: A case report successfully treated with voriconazole and surgical debridement. J Clin Exp Dent. 2014;6(4):e448–51.
- Santosa A, Sari NDP, Putra IBS, Masyeni DAPS. Diagnosis dan tatalaksana rinosinusitis maksilaris odontogenik yang meluas sampai etmoid dan frontal: laporan kasus. Intisari Sains Medis. 2021;12(3):812–6.
- Suresh S, Arumugam D, Zacharias G, Palaninathan S, Vishwanathan R, Venkatraman V. Prevalence and Clinical Profile of Fungal Rhinosinusitis. Allergy Rhinol. 2016;7(2):115–20.
- Aribandi M, McCoy VA, Bazan C. Imaging features of invasive and noninvasive fungal sinusitis: A review. Radiographics. 2007;27(5):1283–96.
- Alshaikh NA, Alshiha KS, Yeak S, Lo S. Fungal Rhinosinusitis: Prevalence and Spectrum in Singapore. Cureus. 2020;12(4):2–14.
- Wahyuningsih R, Adawiyah R, Sjam R, Prihartono J, Ayu Tri Wulandari E, Rozaliyani A, et al. Serious fungal disease incidence and prevalence in Indonesia. Mycoses. 2021;64(10):1203–12.
- P. L. Dhingra SD. Diseases of Ear, Nose and Throat 5th Edition. 2010.
- Craig JR. Updates in management of acute invasive fungal rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2019;27(1):29–36.
- Byron J. Bailey, Jonas T. Johnson SDN, Wilkins LW&. Head & Neck Surgery--otolaryngology. 2006.
How to Cite
Pandu Dewa Natha, & Anak Agung Dewi Adnyani. (2023). Sinusitis maksilaris jamur invasif: laporan kasus. Intisari Sains Medis, 14(2), 601–607. https://doi.org/10.15562/ism.v14i2.1747
