采用积极的手术和药物治疗方法治愈球孢子菌性眼内炎。
Resolution of Coccidioides immitis endophthalmitis with an aggressive surgical and medical therapeutic approach.
作者信息
Reed David C, Shah Kayur H, Hubschman Jean-Pierre
机构信息
Jules Stein Eye Institute, University of California-Los Angeles, CA 90095, USA.
出版信息
Semin Ophthalmol. 2013 Jul;28(4):251-2. doi: 10.3109/08820538.2013.788677. Epub 2013 May 2.
INTRODUCTION
Coccidioides immitis endophthalmitis usually results in enucleation, and there is evidence that vitrectomized eyes are more likely to become enucleated.
METHODS
A 55-year-old man presented to us with steroid-resistant granulomatous uveitis and was eventually diagnosed with C. immitis endophthalmitis. He was treated with an aggressive medical and surgical approach, receiving a total of 16 intravitreal antifungal injections and three vitrectomies, as well as lensectomy and penetrating keratoplasty.
RESULTS
At 13 months after presentation, the patient's eye was free of inflammation, and his best corrected visual acuity was 20/25.
DISCUSSION
This is the first reported case of culture-proven C. immitis endophthalmitis with a favorable final outcome. We propose that the good outcome may have been due to our aggressive therapeutic approach.
引言
粗球孢子菌性眼内炎通常会导致眼球摘除，并且有证据表明接受玻璃体切割术的眼睛更有可能被摘除。
方法
一名55岁男性因对类固醇耐药的肉芽肿性葡萄膜炎前来就诊，最终被诊断为粗球孢子菌性眼内炎。他接受了积极的药物和手术治疗，共接受了16次玻璃体内抗真菌注射、三次玻璃体切割术，以及晶状体切除术和穿透性角膜移植术。
结果
就诊13个月后，患者的眼睛炎症消退，最佳矫正视力为20/25。
讨论
这是首例经培养证实的粗球孢子菌性眼内炎且最终预后良好的病例报告。我们认为良好的预后可能归因于积极的治疗方法。
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