犬鼻窦曲霉病相关颅内积气：内镜介入清创及抗真菌治疗后的康复
Sinonasal aspergillosis-associated pneumocephalus in a dog: recovery after endoscopic interventional debridement and antifungal treatment.
文献信息
| PMID | 42932827 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Manon T A Costes |
| 作者单位 | Small Animal Clinic, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium. |
| 期刊 | Journal of veterinary internal medicine |
| SCI 分区 | Q1 |
| IF | 2.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
一只16岁边境牧羊犬因急性严重淡漠和慢性鼻分泌物转诊。2周前进行的计算机断层扫描（CT）提示鼻窦曲霉病（SNA），伴左侧鼻腔和额窦严重鼻甲破坏及黏膜增厚。未开始治疗。就诊时磁共振成像（MRI）发现脑膜内积气、脑膜炎、额窦炎伴颅腔腹侧局灶性额骨溶解。脑脊液分析无异常，提示淡漠由颅内积气所致。鼻镜检查确认真菌斑块（qPCR：曲霉属）。开始全身抗真菌治疗及内镜清创。尽管存在额骨溶解，也给予了局部抗真菌治疗。3周随访MRI显示颅内积气完全消退。最终影像显示缺损周围瘢痕形成，无活动性感染。这些发现表明，继发于SNA的脑膜内积气可以逆转，不应妨碍抗真菌治疗。内镜治疗干预可能实现完全康复。
英文摘要
A 16-year-old Border Collie was referred for acute severe apathy and chronic nasal discharge. Computed tomography (CT) performed 2 weeks earlier was suggestive of sinonasal aspergillosis (SNA) with severe turbinate destruction and mucosal thickening in the left nasal cavity and frontal sinus. No treatment was initiated. Magnetic resonance imaging (MRI) at presentation identified intrameningeal pneumocephalus, meningitis, frontal sinusitis with ventral focal frontal bone lysis of the cranial cavity. Cerebrospinal fluid analysis was unremarkable, suggesting pneumocephalus as the cause of apathy. Rhinoscopy confirmed fungal plaque (qPCR: Aspergillus spp.). Systemic antifungal treatment and endoscopic debridement were initiated. Despite frontal bone lysis, topical antifungal treatment also was administered. A 3-week follow-up MRI showed complete resolution of pneumocephalus. Final imaging identified scarring around the defect and no active infection. These findings indicate that intrameningeal pneumocephalus secondary to SNA can be reversible and should not preclude antifungal treatment. Endoscopic therapeutic intervention may enable full recovery.