社区获得性耐甲氧西林金黄色葡萄球菌引起眼眶蜂窝织炎导致的双眼失明
Bilateral blindness from orbital cellulitis caused by community-acquired methicillin-resistant Staphylococcus aureus.
作者信息
Rutar Tina, Zwick Orin M, Cockerham Kimberly P, Horton Jonathan C
机构信息
Beckman Vision Center, University of California San Francisco, San Francisco, California 94143-0730, USA.
出版信息
Am J Ophthalmol. 2005 Oct;140(4):740-2. doi: 10.1016/j.ajo.2005.03.076.
PURPOSE
To describe bilateral blindness resulting from infection with community-acquired methicillin-resistant Staphylococcus aureus (MRSA).
DESIGN
Observational case report.
METHODS
A 44-year-old man developed proptosis, ptosis, ophthalmoplegia, and no light perception vision after attempting to lance a nasal pustule. A nasal culture grew MRSA. Imaging showed bilateral orbital cellulitis, pansinusitis, and cavernous sinus thrombosis. The right fundus showed severe ischemia, but the left fundus was essentially normal.
RESULTS
Despite initiation of appropriate antibiotics early in the course of infection, the patient lost sight in both eyes. Surgical drainage of the paranasal sinuses and use of intravenous corticosteroids and heparin led to the resolution of orbital cellulitis.
CONCLUSIONS
MRSA orbital cellulitis can progress to irreversible blindness despite antibiotic treatment. A new, community-acquired clone of this organism has exhibited increased potential for tissue invasion.
目的
描述社区获得性耐甲氧西林金黄色葡萄球菌（MRSA）感染导致的双眼失明。
设计
观察性病例报告。
方法
一名44岁男性在试图刺破鼻脓疱后出现眼球突出、上睑下垂、眼肌麻痹且无光感视力。鼻培养物培养出MRSA。影像学检查显示双侧眼眶蜂窝织炎、全鼻窦炎和海绵窦血栓形成。右眼眼底显示严重缺血，但左眼眼底基本正常。
结果
尽管在感染过程早期就开始使用了适当的抗生素，患者仍双眼失明。鼻旁窦手术引流以及静脉使用皮质类固醇和肝素使眼眶蜂窝织炎得到缓解。
结论
尽管进行了抗生素治疗，MRSA眼眶蜂窝织炎仍可进展为不可逆的失明。这种生物体的一种新的社区获得性克隆已表现出更强的组织侵袭潜力。
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