免疫抑制后孤立性内源性诺卡菌性眼内炎

Isolated endogenous Nocardia endophthalmitis after immunosuppression.

作者信息

Chen Lisa Y, Kesen Muge R, Ghafourian Abdalhossein, Nguyen Quan D, Eberhart Charles G, Do Diana V

机构信息

The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Maumenee 745, Baltimore, MD, 21287, USA.

出版信息

J Ophthalmic Inflamm Infect. 2012 Sep;2(3):141-3. doi: 10.1007/s12348-011-0057-3. Epub 2012 Jan 26.

DOI:10.1007/s12348-011-0057-3

PMID:22278699

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3438302/

Abstract

PURPOSE

This study is aimed to report a case of endogenous Nocardia endophthalmitis in the setting of immunosuppression from chronic steroid use.

METHODS

A case report was conducted.

RESULTS

A 79-year-old woman presented with decreased vision with floaters in the left eye. Ophthalmic examination revealed severe inflammation in the anterior chamber, vitreous opacities, and retinal detachment. Vitreous cultures grew Nocardia farcinica without any systemic foci of infection found during further workup. The patient was treated with intravitreal amikacin and oral trimethoprim-sulfamethoxazole, and her retinal detachment was later repaired in the operating room. The patient has since remained stable with no signs of retinal detachment or active infection.

CONCLUSIONS

Nocardia endophthalmitis is a rare, but serious intraocular infection that should be considered in the differential diagnosis in any immunosuppressed patient, including those receiving steroids, who presents with signs of intraocular infection.

摘要

目的

本研究旨在报告一例因长期使用类固醇导致免疫抑制情况下发生的内源性诺卡菌性眼内炎病例。

方法

进行了一例病例报告。

结果

一名79岁女性因左眼视力下降伴飞蚊症就诊。眼科检查发现前房严重炎症、玻璃体混浊和视网膜脱离。玻璃体培养物培养出豚鼠耳炎诺卡菌，进一步检查未发现任何全身感染病灶。患者接受了玻璃体内注射阿米卡星和口服甲氧苄啶 - 磺胺甲恶唑治疗，随后在手术室修复了视网膜脱离。此后患者病情一直稳定，无视网膜脱离或活动性感染迹象。