RESUMO
Acute fulminant invasive fungal sinusitis is most commonly found in immunocompromised patients with conditions such as diabetes mellitus, malignancies and acquired immune deficiency syndrome. The most common pathogens are Aspergillus and Mucoraceae and the sinus most frequently involved is the maxillary sinus. Fever, rhinorrhea, facial pain, headache, and diplopia are common presenting symptoms. Complications of this infection include intracranial and / or intraorbital spread of the infection; the prognosis is poor. Here, a rare case of acute fulminant invasive fungal sinusitis with cavernous sinus syndrome is reported.
Assuntos
Aspergilose/diagnóstico , Seio Cavernoso/patologia , Diabetes Mellitus Tipo 2/complicações , Sinusite/diagnóstico , Doença Aguda , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Cefaleia/etiologia , Humanos , Hospedeiro Imunocomprometido , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Sinusite/microbiologia , Sinusite/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
BACKGROUND: Noise-induced hearing loss (NIHL) is one of the common diseases in otology. In general, we assume that most people who are exposed to loud noise constantly, e.g., soldiers, will suffer from hearing loss. Hearing loss is related to the gene polymorphisms, with the Wolfram syndrome type 1 gene (T2500C), interleukin-4 receptor α chain (Q576R) and chloride channel-Kb (T481S) polymorphisms being most related to NIHL. METHODS: We analyzed the association between the polymorphisms and the risk of NIHL in 119 subjects who were exposed to the same loud gunfire. In the current study, 39 persons with hearing loss and 80 with normal hearing were recruited from military officers and soldiers that were exposed to gunfire. RESULTS: The results showed that the genetic variation of Wolfram syndrome type 1 gene was a more crucial factor than other genes in causing hearing loss. There was a significant difference (p=0.027) in WFS1 (T2500C) polymorphism between NIHL subjects and controls. CONCLUSION: In this study, we found that although loud noise could usually result in hearing damage, the clinical characteristics of hearing loss were irrelevant to gunfire noise. The gene polymorphisms provide predictors for us to evaluate the risk of NIHL prior to gunshot training.