Guigon B, Trepsat C
Service d'ophtalmologie, HIA Legouest, 57998 Metz armées, France.
J Fr Ophtalmol. 2002 Jan;25(1):78-80.
The authors describe a case of intraocular cysticercosis discovered in the ophthalmology department ef Edouard Herriot Hospital. With no biological signs, the diagnosis was made after vitrectomy because the visit was late in the course of the disorder, the patient lived in the mountains, and he had failed to mention a trip to the West Indies 3 months before. The symptomatology began with uveitis worsened in 10 days by greater inflammation in spite of successive corticosteroids, antibiotic, and antiviral therapy. Repeated examination and serological and radiological investigations did not help establish the etiology. Only vitrectomy provided the diagnosis, the vitreous containing cysticercus. This discover was all the more surprising that the patient lived in the French Alps and a trip 3 months before had been forgotten. A review ol the literature allowed us to rapidly start a postoperative parasite examination to check for cerebral, muscular, cardiac, and subcutaneous localizations and to start treatment with praziquantel (50 mg/kg per day) with corticotherapy (1 mg/kg per day). The eye evolved toward a very inflammatory phthisis, which led to evisceration.
作者描述了一例在爱德华·赫里奥特医院眼科发现的眼内囊尾蚴病病例。由于没有生物学体征,诊断是在玻璃体切除术后做出的,因为就诊时病情已处于晚期,患者居住在山区,且他未提及3个月前曾去过西印度群岛。症状始于葡萄膜炎,尽管先后使用了皮质类固醇、抗生素和抗病毒治疗,但在10天内炎症加剧,病情恶化。反复检查以及血清学和放射学检查均未能明确病因。只有玻璃体切除术提供了诊断依据,玻璃体中含有囊尾蚴。这一发现更加令人惊讶,因为患者居住在法国阿尔卑斯山,且3个月前的一次旅行被遗忘了。查阅文献后,我们迅速在术后进行了寄生虫检查,以检查脑部、肌肉、心脏和皮下的病变情况,并开始使用吡喹酮(每天50毫克/千克)和皮质激素疗法(每天1毫克/千克)进行治疗。眼部发展为严重的炎性眼球痨,最终导致眼球摘除。