肾移植术后患者并发神经感染的双侧急性视网膜坏死。

Bilateral acute retinal necrosis associated with neuroinfection in patient after renal transplantation.

机构信息

Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Med Sci Monit. 2011 Aug;17(8):CS99-102. doi: 10.12659/msm.881890.

DOI:10.12659/msm.881890

PMID:21804470

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3539611/

Abstract

BACKGROUND

Acute retinal necrosis (ARN) is characterized by the triad of acute vitritis, peripheral necrotizing retinitis and vasculitis.

CASE REPORT

We report a case of 54-year-old woman with bilateral acute retinal necrosis associated with neuroinfection. Her past medical history included renal transplantation, hypertension and aortic stenosis. Observational case report: Diagnostic investigations included biochemical tests, lumbar puncture, eye ultrasonography and MRI of the brain. Anti-HSV IgG antibody titers were elevated in the blood and cerebrospinal fluid. In MRI T2-mode, inflammatory changes were found in the white matter of the right hemisphere. The patient was treated with systemic acyclovir, itraconazole, metronidazole and ciprofloxacin for 3 weeks. Retinal detachment was observed in both eyes.

CONCLUSIONS

Acute retinal necrosis can be the single manifestation of herpes virus reactivation in patients after organ transplantation.

摘要

背景

急性视网膜坏死（ARN）的特征是三联征，包括急性眼炎、周边坏死性视网膜炎和血管炎。

病例报告

我们报告了一例 54 岁女性双侧急性视网膜坏死伴神经感染。她的既往病史包括肾移植、高血压和主动脉瓣狭窄。观察性病例报告：诊断性检查包括生化检查、腰椎穿刺、眼部超声和脑部 MRI。血液和脑脊液中的抗单纯疱疹病毒 IgG 抗体滴度升高。在 MRI T2 模式中，发现右侧大脑半球白质有炎症改变。患者接受了全身性阿昔洛韦、伊曲康唑、甲硝唑和环丙沙星治疗 3 周。双眼均出现视网膜脱离。