Manocha Divey, Tenorio Cristian Del Carpio, Rose Fredrick
Internal Medicine, Suny Upstate Medical University NY 13210 USA.
Cases J. 2009 Jul 23;2:6293. doi: 10.4076/1757-1626-2-6293.
Elderly lady underwent right eye surgery for vitreous clot removal. 72 hours later, she complained of pain, redness and swelling in operated eye. Endophthalmitis was diagnosed. She was started on piperacillin/ tazobactam and vancomycin. Evisceration was required. Coagulase negative Staphylococci were isolated and vancomycin was continued postoperatively. She was discharged on home intravenous vancomycin therapy. Admitted one week later with painful oral ulcers, fever and diffuse erythmatous body rash. Vancomycin and other medications were stopped. Investigations revealed elevated double-stranded deoxyribonucleic acid and anti histone antibodies. Skin biopsy was suggestive of lupus rash. She was started on 60 mg of oral prednisone, improved dramatically and discharged to home.
一位老年女性接受了右眼玻璃体血块清除手术。72小时后,她抱怨手术眼疼痛、发红和肿胀。诊断为眼内炎。开始使用哌拉西林/他唑巴坦和万古霉素治疗。需要进行眼球内容剜除术。分离出凝固酶阴性葡萄球菌,术后继续使用万古霉素。她出院后接受家庭静脉注射万古霉素治疗。一周后因疼痛性口腔溃疡、发热和全身性弥漫性红斑疹入院。停用万古霉素和其他药物。检查发现双链脱氧核糖核酸和抗组蛋白抗体升高。皮肤活检提示为狼疮疹。开始口服60毫克泼尼松,病情显著改善后出院回家。