咽部放线菌病6例临床分析

doi:10.6040/j.issn.1673-3770.0.2020.054

摘要/Abstract

摘要： 目的总结咽部放线菌病患者的临床资料,探讨其临床特征和诊疗方法。方法回顾性分析2015年9月至2019年10月收治的咽部放线菌病6例,行电子鼻咽喉镜检查、特异性感染筛查、分泌物培养、组织活检病理检查。采用青霉素类抗生素、局部清理、雾化吸入等综合治疗。结果所有病例均确诊为放线菌病,经治疗后症状全部改善,病灶消失,随访3个月~1年无复发。结论咽部放线菌病与局部慢性病变相关,主要依靠病理学检查确诊,抗生素、雾化、局部清理的综合治疗效果确切。

关键词: 放线菌病, 咽部, 治疗

Abstract: Objective To summarize the clinical data of patients with pharyngeal actinomycosis and discuss the clinical characteristics, diagnosis, and treatment methods. Methods Six cases of pharyngeal actinomycosis diagnosed between September 2015 and October 2019 by a combination of video rhinolaryngoscopy, screening for specific infection, secretion culture, and biopsy were evaluated. The patients were treated with penicillin antibiotics, local cleaning, and atomization inhalation. Results All cases were diagnosed as pharyngeal actinomycosis, and all the lesions disappeared, accompanied by symptomatic relief “After treatment”. there was no recurrence during the 3 months to 1 year of follow-ups. Conclusion Pharyngeal actinomycosis is related to local chronic disease, and it is mainly confirmed by pathological examination. Comprehensive treatment with antibiotics, atomization, and local cleaning have definite outcomes.

Key words: Actinomycosis, Pharynx, Treatment

中图分类号:

R519.1

敬前程,龚巍,周定刚,周芳. 咽部放线菌病6例临床分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 54-57.

JING Qiancheng, GONG Wei, ZHOU Dinggang, ZHOU Fang. Clinical analysis of 6 cases of pharyngeal actinomycosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 54-57.

参考文献

[1] Carvalho de Medeiros F, Carvalho de Medeiros F. Tonsillar actinomycosis mimicking relapse of diffuse large B-cell non-Hodgkin lymphoma[J]. Rev Chilena Infectol, 2016, 33(5): 576-579. doi:10.4067/S0716-10182016000500015.
[2] 李宗华, 张顺霞. 鼻石并放线菌病1例[J]. 临床耳鼻咽喉头颈外科杂志, 2013, 27(2): 103. doi:10.13201/j.issn.1001-1781.2013.02.021. LI Zonghua, ZHANG Shunxia. A case of rhinolith and actinomycosis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2013, 27(2): 103. doi:10.13201/j.issn.1001-1781.2013.02.021.
[3] Lee Dong Hoon, Yoon Tae Mi, Lee Joon Kyoo, et al. Nasal Septum Actinomycosis Mimicking Mucocele[J]. J Craniofac Surg, 2020, 31(2):e147-e149. doi: 10.1097/SCS.0000000000006078.
[4] Pulverer G, Schütt-Gerowitt H, Schaal KP. Human cervicofacial actinomycoses: microbiological data for 1997 cases[J]. Clin Infect Dis, 2003, 37(4): 490-497. doi:10.1086/376621.
[5] 李振光. 鼻咽放线菌病的诊断与治疗[J]. 医学临床研究, 2006(5): 689-690. doi:10.3969/j.issn.1671-7171.2006.05.019 LI Zhenguang. Treatment and diagnosis of nasopharyngeal actinomycosis[J]. Journal of Clinical Research, 2006(5): 689-690. doi:10.3969/j.issn.1671-7171.2006.05.019.
[6] W Gomes-Silva, D-L Pereira, E-R Fregnani, et al. Clinicopathological and ultrastructural characterization of periapical actinomycosis[J]. Med Oral Patol Oral Cir Bucal, 2020, 25(1):e131-e136. doi: 10.4317/medoral.23247.
[7] Yanagisawa R, Minami K, Kubota N, et al. Asymptomatic subcutaneous cervical mass due to Actinomyces odontolyticus infection in a pyriform sinus fistula[J]. Pediatr Int, 2017, 59(8): 941-942. doi:10.1111/ped.13321.
[8] Gannepalli A, Ayinampudi BK, Baghirath PV, et al. Actinomycotic osteomyelitis of maxilla presenting as oroantral fistula: a rare case report[J]. Case Rep Dent, 2015, 2015: 689240. doi:10.1155/2015/689240.
[9] 李清明, 吴思恩, 黄素红, 等. 第三腮裂瘘管诊治6例并文献复习[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 61-64. doi:10.6040/j.issn.1673-3770.0.2016.041. LI Qingming, WU Si'en, HUANG Suhong, et al. Diagnosis and treatment of the third branchial cleft fistula: a clinical report of 6 cases and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(3): 61-64. doi:10.6040/j.issn.1673-3770.0.2016.041.
[10] 郭树檀, 冀丽彬, 陈沐群. 先天性耳前瘘管手术感染放线菌病1例[J]. 中国误诊学杂志, 2001, 1(1): 99. doi:10.3969/j.issn.1009-6647.2001.01.117.
[11] 马建业, 窦乃迪, 韩智鹏. 扁桃体放线菌病5例[J]. 山东大学耳鼻喉眼学报, 2011, 25(6): 94-95.
[12] 李嘉.上颌窦放线菌混合感染一例[J]. 中华耳鼻咽喉头颈外科杂志, 2013,48(4):346-347. doi:10.3760/cma.j.issn.1673-0860. 2013.04.021.
[13] 李振光. 鼻咽放线菌病的诊断与治疗[J]. 医学临床研究, 2006(5): 689-690. doi:10.3969/j.issn.1671-7171. 2006.05.019. LI Zhenguang. Treatment and diagnosis of nasopharyngeal actinomycosis[J]. Journal of Clinical Research, 2006(5): 689-690. doi:10.3969/j.issn.1671-7171.2006.05.019.
[14] 杨娜, 孙克巍. 喉放线菌感染合并肉芽增生1例[J]. 中国耳鼻咽喉头颈外科, 2010, 17(3): 159. doi:10.16066/j.1672-7002.2010.03.018.
[15] Lipowska AM, Johns MM 3rd. Actinomycosis of the pharynx[J]. Ear Nose Throat J, 2014, 93(9): 404-408.
[16] Fiorella D'Amore, Roberto Franchini, Laura Moneghini, et al. Actinomycosis of the Tongue: a case report and review of literature[J]. Antibiotics(Basel), 2020, 9(3). doi: 10.3390/antibiotics9030124.
[17] Stabrowski T, Chuard C. Actinomycosis[J]. Revue Med Suisse, 2019,15(666):1790-1794.
[18] Ozgursoy Ozan Bagis, Kemal Ozgur, Saatci Mustafa Rahmi et al. Actinomycosis in the etiology of recurrent tonsillitis and obstructive tonsillar hypertrophy: answer from a histopathologic point of view.[J]. J Otolaryngol Head Neck Surg, 2008, 37: 865-869.
[19] Asgary Saeed, Talebzadeh Bita. Surgical endodontics for management of progressive actinomycosis[J]. General dentistry,2020,68(1).
[20] Bhargava D, Bhusnurmath B, Sundaram K R, et al. Tonsillar actinomycosis: a clinicopathological study[J]. Acta Trop, 2001, 80: 163-168. doi:10.1016/s0001-706x(01)00172-3.
[21] Balbinot KM, Sousa NWA, Pinheiro JDJV, et al. Surgical debridement as a treatment strategy for cervicofacial actinomycosis: Literature review and case report[J]. Int J Surg Case Rep, 2020, 73: 22-26. doi:10.1016/j.ijscr.2020.06.079.
[22] Kaila V, Moturi K. Cervicofacial actinomycosis and its management[J]. Ann Maxillofac Surg, 2018, 8(2): 361. doi:10.4103/ams.ams_176_18.

相关文章 15

[1]	方璐, 雷玉丹, 王华. 环孢素滴眼液联合玻璃酸钠滴眼液治疗干眼临床效果的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 65-73.
[2]	雷玉丹,方璐,陈健,彭昌福. 托珠单抗治疗激素抵抗或不耐受的中重度甲状腺相关性眼病临床疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 54-67.
[3]	朱明琼,李征,刘茹,田涛,彭婧利,吕倩怡,谭华霞. 基于OCT/OCTA的AI筛查系统在抗VEGF治疗糖尿病性黄斑水肿患者效果评价中的应用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 68-73.
[4]	卢朝阳, 翟兆雪, 王慧康, 邵丽婷, 张宇. 新冠肺炎治疗引发糖尿病酮症酸中毒合并鼻眶脑型毛霉菌病1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 90-94.
[5]	顾敏,陆美萍. 纳米药物输送系统在变应性鼻炎过敏原免疫治疗中的应用进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 106-111.
[6]	刘一洁,卢秀珍,吴秋欣. 外泌体在眼病发病机制和诊疗中的研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 135-141.
[7]	刘玉柱,陈尧,苑铁君,李春森,李波. 喉纤维肉瘤1例并相关文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 133-137.
[8]	韩鑫宇,陈钢钢,李莹,周丽媛,杨捷,吴佳鑫,李育军. 双侧前庭病的非药物治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 154-159.
[9]	王晓杰,张明君,宋哲莹,崔丽梅,宋西成. 山奈酚抗癌的作用机制及研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 168-178.
[10]	许雪萌,樊磊,喻望博,蒋芝月,潘晨,黄泳芹. 奥马珠单抗联合特异性免疫治疗变应性鼻炎疗效的Meta分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 26-33.
[11]	刘玉柱,苑铁君,李波. 会厌原发神经内分泌癌1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 97-100.
[12]	张婷,王美兰,高映勤. 白细胞介素35在变应性鼻炎中的研究进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 139-147.
[13]	邱前辉,肖旭平,杨钦泰,叶菁,邓泽义,王德生,谭国林,蒋卫红,卢永田,唐隽,石照辉,邓晓聪,刘遗斌,王跃武,段传志,杜德坤,白小欣,陈文伙,莫立根,蔡楚伟,曾鹏,何旭英,杨一梅,赵洲洋,陈健龙,赵充,林志雄,李先明,李曙平,陈冬平,陈勇,黄莹,陈春燕,韩非,黄理金,瞿申红. 鼻咽癌治疗后并发颈动脉爆裂综合征的临床处理专家共识[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 1-18.
[14]	朱瑞楷,吴家荣,孙芳,谢楚波,邱前辉. 基于计算机断层扫描血管造影术评估鼻咽癌放疗后引起颈内动脉狭窄状况及其影响因素的研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 77-84.
[15]	石金莲,李建兴,黄幼生,林铭轩,刘灵云,卢永田. 喉部炎性肌纤维母细胞瘤的研究现状与诊疗进展[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 186-192.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed