[同侧单纯疱疹病毒性脑炎10个月后发生暴发性急性视网膜坏死——病例报告]
[Fulminant acute retinal necrosis 10 months after ipsilateral herpes simplex virus encephalitis - a case report].
作者信息
Bergua A, Schmidt B, Küchle M
机构信息
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen.
出版信息
Klin Monbl Augenheilkd. 2001 Nov;218(11):737-40. doi: 10.1055/s-2001-18666.
BACKGROUND
Cases of acute retinal necrosis caused by herpes simplex virus are rare. We present here a case with a very fast progression 10 months after a primary herpetic encephalitis in an immunocompetent patient.
CASE REPORT
A 36-year-old otherwise healthy man presented in our hospital with an acute painless loss of vision on the left eye. Initial examination of the fundus showed peripheral retinal necrosis with intra- and preretinal haemorrhages and sheathing of retinal venules. Diagnosis was made by detection of viral DNA in vitreous fluid. Although an antiviral therapy with high doses of acyclovir was started, a vitrectomy with silicon oil instillation was necessary to stabilise the necrotic retina.
CONCLUSION
Acute retinal necrosis is relatively rare, and fast diagnosis is required. A detailed case history with attention to previous infections with herpes simplex virus as well as clinical signs were the key for the diagnosis.
背景
单纯疱疹病毒引起的急性视网膜坏死病例罕见。我们在此报告一例免疫功能正常的患者，在原发性疱疹性脑炎10个月后病情进展迅速。
病例报告
一名36岁身体健康的男性因左眼急性无痛性视力丧失入院。眼底初步检查显示周边视网膜坏死，伴有视网膜内和视网膜前出血以及视网膜静脉鞘膜形成。通过检测玻璃体液中的病毒DNA做出诊断。尽管开始了大剂量阿昔洛韦的抗病毒治疗，但仍需要进行玻璃体切除术并注入硅油以稳定坏死的视网膜。
结论
急性视网膜坏死相对罕见，需要快速诊断。详细的病史，关注既往单纯疱疹病毒感染情况以及临床体征是诊断的关键。
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