尖端赛多孢子菌性脉络膜视网膜炎
Scedosporium apiospermum chorioretinitis.
作者信息
Kiratli H, Kiraz N, Eldem B
机构信息
Department of Ophthalmology, Section of Infectious Diseases, Hacettepe School of Medicine, Hacettepe University, Ankara, Turkey.
出版信息
Acta Ophthalmol Scand. 2001 Oct;79(5):540-2. doi: 10.1034/j.1600-0420.2001.790524.x.
PURPOSE
A case of a 24-year-old immunocompetent woman who developed unilateral Scedosporium apiospermum chorioretinitis and diffuse cervical lymphadenitis 10 years after facial steroid injection is described.
METHODS
The patient was initially treated for the misdiagnosis of tuberculous lymphadenitis. Contemporaneous to the enlargement of her lymph nodes, she experienced gradual loss of vision in her left eye. She subsequently underwent lymph node biopsy.
RESULTS
Histopathologic sections stained with Grocott's methenamine silver showed branched septate hyphae and cultures on Sabouraud's agar yielded Scedosporium apiospermum. The patient received oral itraconazole 200 mg twice daily. Lymphadenitis regressed within a year and chorioretinitis scarred within two years.
CONCLUSION
Scedosporium apiospermum may cause isolated chorioretinitis in an immunocompetent individual years after local surgery or trauma and result in significant visual morbidity. Treatment may require prolonged use of systemic itraconazole.
目的
描述一例24岁免疫功能正常的女性，在面部注射类固醇10年后发生单侧阿氏假霉样真菌性脉络膜视网膜炎和弥漫性颈部淋巴结炎。
方法
患者最初因结核性淋巴结炎误诊而接受治疗。在淋巴结肿大的同时，她左眼视力逐渐下降。随后她接受了淋巴结活检。
结果
用Grocott六胺银染色的组织病理学切片显示有分支的分隔菌丝，在沙氏琼脂上培养出阿氏假霉样真菌。患者接受口服伊曲康唑，每日两次，每次200毫克。淋巴结炎在一年内消退，脉络膜视网膜炎在两年内形成瘢痕。
结论
阿氏假霉样真菌可能在局部手术或创伤数年之后，在免疫功能正常的个体中引起孤立性脉络膜视网膜炎，并导致严重的视力损害。治疗可能需要长期使用全身性伊曲康唑。
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