眼脸蜱传伯氏疏螺旋体病，一种莱姆病的不常见表现。

Oculopalpebral borreliosis as an unusual manifestation of Lyme disease.

机构信息

Institute of Applied Bio-Ophthalmology, University of Valladolid, Valladolid, Spain.

出版信息

Cornea. 2013 Jan;32(1):87-90. doi: 10.1097/ICO.0b013e318243e45c.

DOI:10.1097/ICO.0b013e318243e45c

PMID:22495033

Abstract

PURPOSE

To report the case of acrodermatitis chronica atrophicans as an ocularpalpebral manifestation of Lyme borreliosis, with peripheral keratopathy and associated vasculitis.

METHODS

Case report.

RESULTS

A 16-year-old girl, with a 4-year history of recurrent left eye photophobia, intense redness, and superior eyelid edema, presented with lid erythema, ptosis, superficial venous tortuosity, conjunctival hyperemia, corneal thinning with precipitates, and vascularization. Borrelia burgdorferi was confirmed by immunoblotting. Treatments with doxycycline followed by ceftriaxone were only partially effective. Eyelid biopsy revealed spirochetes and vasculitis with deposition of immunoglobulin G. Oral cefuroxime for 28 days was ineffective. Due to the vasculitis, immunosuppression with azathioprine and topical cyclosporine were given for 4 months. Since then she has been free of flare-ups.

CONCLUSIONS

Lyme borreliosis should be considered in patients with recurrent chronic lid edema and associated keratopathy.

摘要

目的

报告一例慢性萎缩性肢端皮炎作为莱姆病眼部表现的病例，伴有周边性角膜病变和相关血管炎。

方法

病例报告。

结果

一名 16 岁女孩，左眼反复出现畏光、剧烈眼红和上眼睑水肿 4 年，表现为眼睑红斑、上睑下垂、表浅静脉扭曲、结膜充血、角膜变薄伴沉淀物和血管化。免疫印迹法证实为伯氏疏螺旋体。多西环素和头孢曲松治疗仅部分有效。眼睑活检显示螺旋体和血管炎伴 IgG 沉积。28 天口服头孢呋辛无效。由于血管炎，给予硫唑嘌呤免疫抑制和环孢素滴眼液治疗 4 个月。此后，她未再出现发作。