Dugel P U, Rao N A, Forster D J, Chong L P, Frangieh G T, Sattler F
A. Ray Irvine, Jr., Eye Pathology Laboratory, Doheny Eye Institute, Los Angeles, CA 90033.
Am J Ophthalmol. 1990 Aug 15;110(2):113-7. doi: 10.1016/s0002-9394(14)76978-8.
Pneumocystis carinii pneumonia is a major cause of morbidity and mortality in patients with the acquired immunodeficiency syndrome. When P. carinii is disseminated, the choroid may be involved and the infection is often fatal. We examined, treated, and followed up two patients who developed choroidal lesions typical of P. carinii while taking aerosolized pentamidine for prophylaxis. The choroidal lesions gradually resolved after three weeks of therapy with intravenous trimethoprim and sulfamethoxazole in one patient, and after three weeks of therapy with parenteral pentamidine in the other patient. The patients did not have clinical or laboratory evidence of P. carinii infection other than in the eye. It thus appears that early ophthalmologic examination may detect disease before it is threatening to sight and allow systemic therapy to be instituted before widely disseminated infection results in a fatal outcome.
卡氏肺孢子虫肺炎是获得性免疫缺陷综合征患者发病和死亡的主要原因。当卡氏肺孢子虫播散时，脉络膜可能受累，且感染往往是致命的。我们检查、治疗并随访了两名在接受雾化喷他脒预防治疗时出现典型卡氏肺孢子虫脉络膜病变的患者。其中一名患者在接受静脉注射甲氧苄啶和磺胺甲恶唑治疗三周后，脉络膜病变逐渐消退；另一名患者在接受胃肠外给予喷他脒治疗三周后，病变逐渐消退。除眼部外，这两名患者没有卡氏肺孢子虫感染的临床或实验室证据。因此，早期眼科检查似乎可以在疾病威胁视力之前检测到疾病，并在广泛播散性感染导致致命后果之前进行全身治疗。
