Halperin S A, La Roche G R
Departments of Pediatrics, Ophthalmology, and Microbiology, Dalhousie University; and the Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia.
Can J Infect Dis. 1993 Jan;4(1):15-20. doi: 10.1155/1993/576891.
Cytomegalovirus retinitis is the most severe ophthalmological complication of patients with acquired immune deficiency syndrome (aids). Ganciclovir must be given continuously to control progression of the disease or relapse typically occurs. Data in children are limited; this report describes a nine-year-old boy with transfusion-acquired aids who was treated with ganciclovir for 23 months for control of cytomegalovirus retinitis. The retinal disease was exacerbated when ganciclovir was temporarily withheld because of presumed drug toxicity, and improved with re-institution of therapy. When ganciclovir was finally discontinued because of complete loss of vision, the patient rapidly deteriorated and died; widespread cytomegalovirus infection was found at autopsy. Subcapsular cataracts appearing during therapy were thought to be a toxic effect of ganciclovir. Ganciclovir can be effective in controlling cytomegalovirus retinitis in children; however, similarities in laboratory findings may lead to confusion between systemic drug toxicity and disease progression.
巨细胞病毒性视网膜炎是获得性免疫缺陷综合征（艾滋病）患者最严重的眼科并发症。必须持续给予更昔洛韦以控制疾病进展，否则通常会复发。儿童患者的数据有限；本报告描述了一名9岁因输血感染艾滋病的男孩，他接受了23个月的更昔洛韦治疗以控制巨细胞病毒性视网膜炎。由于推测药物毒性而暂时停用更昔洛韦时，视网膜疾病加重，重新开始治疗后病情改善。当最终因完全失明而停用更昔洛韦时，患者病情迅速恶化并死亡；尸检发现广泛的巨细胞病毒感染。治疗期间出现的囊下白内障被认为是更昔洛韦的毒性作用。更昔洛韦可有效控制儿童巨细胞病毒性视网膜炎；然而，实验室检查结果的相似性可能会导致全身药物毒性和疾病进展之间的混淆。
